Child Care Case Number: Client Address
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Client’s Educational Program/Goal: Client Phone Number
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Client email address (if known
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If client has obtained employment in their field of study
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https://content.dcf.ks.gov/EES/KEESM/Forms/ES-1640a_8_14.docView duplicates
Contact name/number(s) for family
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CPS Specialist’s Email
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☐ No ☐ Yes (If yes, list name
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Dates/Times CPS Specialist/Family Preservation Liaison is available for Initial Family Meeting
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_4000_Forms/PPS4200.docx
HI - Home Interview OI - Office Interview CMA - Case Management Activities ET- E-mail To
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From LT - Letter To LF - Letter From EF- E-mail From
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_10000_Forms/PPS10200.doc
Economic and Employment Services IS-4315 Rev. 04-16
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Describe the basis of the consumer’s incapacity/disability and attach copies of any available medical, psychological or psychiatric
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https://content.dcf.ks.gov/EES/KEESM/Forms/Referral to Rehabilitation Services.docxView duplicates
SECTION I: Information about current court case
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Court reports to include information relevant to the current court case only
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Reports to be provided to the courts in advance of the
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Email
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_3000_Forms/PPS3004.docx
DCF Grant Request for Proposal (RFP
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Centers for Independent Living: Covering Kansas Counties with Core Services
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DCF Grant Manager via e-mail at dcf.grants@ks.gov
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https://www.dcf.ks.gov/Agency/Operations/Documents/Old RFP's and RFP Amendments/Centers for Independent Living RFP.doc
02-17 INSTRUCTIONS: Complete this form and email to DCF.EBTMAIL@ks.gov within 20 days of
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Retain original in the case file
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TYPE OF ACTIVITY (CHECK ONE) ADD CHANGE DELETE 1. NAME
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https://content.dcf.ks.gov/EES/KEESM/Forms/ES-524_FS_Disqualification02-17.docView duplicates
Department for Children and Families REV. Jan-25
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KIPS Investigation ID: Click or tap here to
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Email: dataadmin@ksgprog.org & cc KGP Regional Liaison
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Email: Click or tap here to enter text
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_10000_Forms/PPS10600A.docx
DEPARTMENT OF SOCIAL AND REHABILITATION SERVICES
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A. APPLICANT AGENCY (NAME, ADDRESS, TELEPHONE
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D. PROJECT DIRECTOR (NAME, TITLE, ADDRESS, TELEPHONE, E-MAIL
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Font size may be 10 point
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https://www.dcf.ks.gov/services/PPS/Documents/Grant_Information/SFY12FamilyResourceProjectGrantApplication.docx
Client is being referred to the Workforce Center to register for a KANSASWORKS Plus account and to enroll in Career Ready 101
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Client is scheduled to visit the Workforce Center by
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EMAIL
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https://content.dcf.ks.gov/EES/KEESM/Forms/ES-4418_CR101_Referral_Turn_Around_Form_01-21.docView duplicates