WACF Application - Washington Association for Children & Families

Agency Location:
Agency/Individual Name*
Address*
Street Address City State / Province / Region ZIP / Postal Code Country
About Your Agency:
Agency’s Mission*
Current DCYF Child Welfare Contracts*
What other contracts does your agency hold?*
Organization Contract(s) Status
Level of Participation

Participation Explanation:

Participation as a full-voting Organizational Member:
Agencies or entities that have DCYF child welfare serving contracts including in-home services, child placing agencies and behavioral rehabilitation services. (This excludes agencies who primarily serve early learning- see supporting organization).

Participation as a non-voting Partnering Organization:
Agencies or entities whose primary focus is legislative, administrative, and/or local advocacy on behalf of children and families.

Participation as a non-voting Supporting Organization:
Agencies that support families involved with or at risk of involvement with the child welfare system, whose primary sources of funding are not through DCYF contracts.
Choose One:
Level of participation:*
- Participation as a full-voting Organizational Member
- Participation as a non-voting Partnering Organization
- Participation as a non-voting Supporting Organization
What are your annual child welfare expenses?

Full-voting Organizational Members Only Child welfare expenses are agency expenses related to child welfare services. These include: foster care, group care, visitation, family preservation & support services, and independent living skills. It does not include: early learning, home visiting, child mental health, community mental health, homeless family prevention & intervention support services.
Main Contact Person/CEO/ED:
Main Contact*
Job Title
Phone*
Email*
WACF is composed of four divisions:

Choose one or more (if applicable) and enter the required information. If you are a Supporting Organization this does not apply. Please skip to the Form Submitter section below.
Division Explanation:

The Child Placing Agencies (CPA) Division, is composed of private, community based foster care agencies that recruit, license, train and support foster families. Child Placing Agencies work collaboratively with DCYF to ensure timely permanency.

The Intensive Services Division, is composed of agencies that provide Behavioral Rehabilitation Services, Crisis Residential Centers, HOPE beds, Regional Assessment Centers, therapeutic foster care and other services designed to serve children, youth, and their families with multidimensional and complex needs.

The Family Preservation and Support Services (FPSS) Division, is composed of agencies that provide in-home and community-based services to families, with the goal of stabilizing families to prevent children from entering more intensive services, including out-of-home care.

The Independent Living (IL) Division, is composed of agencies that provide services designed to assist youth and young adults ages 15 - 23 in making the transition from foster care to self-sufficiency.

Choose applicable division(s)
Choose applicable division(s):
- Child Placing Agencies
- Intensive Services
- Family Preservation & Support Services
- Independent Living
Agency Rep Name for CPA*
Agency Rep Email*
Agency Rep Name for IS*
Agency Rep Email*
Agency Rep Name for FPSS*
Agency Rep Email*
Agency Rep Name for IL*
Agency Rep Email*
Form Submitter:
Consent
I agree to the following.
I am authorized to speak and make commitments pursuant to participation on behalf of the organization noted in this application. I give permission to use the organization name in any written materials or publications of the Washington Association for Children and Families. It is my responsibility to ensure that the person that I have selected to represent our agency in any applicable division meetings will be permitted to make decisions on behalf of my agency or there is a process in which my agency makes decisions.
Your name*
Your title*
CAPTCHA

Agency Location:
Agency/Individual Name*
Address*
Street Address City State / Province / Region ZIP / Postal Code Country
About Your Agency:
Agency’s Mission*
Current DCYF Child Welfare Contracts*
What other contracts does your agency hold?*
Organization Contract(s) Status
Level of Participation

Participation Explanation:

Participation as a full-voting Organizational Member:
Agencies or entities that have DCYF child welfare serving contracts including in-home services, child placing agencies and behavioral rehabilitation services. (This excludes agencies who primarily serve early learning- see supporting organization).

Participation as a non-voting Partnering Organization:
Agencies or entities whose primary focus is legislative, administrative, and/or local advocacy on behalf of children and families.

Participation as a non-voting Supporting Organization:
Agencies that support families involved with or at risk of involvement with the child welfare system, whose primary sources of funding are not through DCYF contracts.
Choose One:
Level of participation:*
- Participation as a full-voting Organizational Member
- Participation as a non-voting Partnering Organization
- Participation as a non-voting Supporting Organization
What are your annual child welfare expenses?

Full-voting Organizational Members Only Child welfare expenses are agency expenses related to child welfare services. These include: foster care, group care, visitation, family preservation & support services, and independent living skills. It does not include: early learning, home visiting, child mental health, community mental health, homeless family prevention & intervention support services.
Main Contact Person/CEO/ED:
Main Contact*
Job Title
Phone*
Email*
WACF is composed of four divisions:

Choose one or more (if applicable) and enter the required information. If you are a Supporting Organization this does not apply. Please skip to the Form Submitter section below.
Division Explanation:

The Child Placing Agencies (CPA) Division, is composed of private, community based foster care agencies that recruit, license, train and support foster families. Child Placing Agencies work collaboratively with DCYF to ensure timely permanency.

The Intensive Services Division, is composed of agencies that provide Behavioral Rehabilitation Services, Crisis Residential Centers, HOPE beds, Regional Assessment Centers, therapeutic foster care and other services designed to serve children, youth, and their families with multidimensional and complex needs.

The Family Preservation and Support Services (FPSS) Division, is composed of agencies that provide in-home and community-based services to families, with the goal of stabilizing families to prevent children from entering more intensive services, including out-of-home care.

The Independent Living (IL) Division, is composed of agencies that provide services designed to assist youth and young adults ages 15 - 23 in making the transition from foster care to self-sufficiency.

Choose applicable division(s)
Choose applicable division(s):
- Child Placing Agencies
- Intensive Services
- Family Preservation & Support Services
- Independent Living
Agency Rep Name for CPA*
Agency Rep Email*
Agency Rep Name for IS*
Agency Rep Email*
Agency Rep Name for FPSS*
Agency Rep Email*
Agency Rep Name for IL*
Agency Rep Email*
Form Submitter:
Consent
I agree to the following.
I am authorized to speak and make commitments pursuant to participation on behalf of the organization noted in this application. I give permission to use the organization name in any written materials or publications of the Washington Association for Children and Families. It is my responsibility to ensure that the person that I have selected to represent our agency in any applicable division meetings will be permitted to make decisions on behalf of my agency or there is a process in which my agency makes decisions.
Your name*
Your title*
CAPTCHA

We Are Stronger Together!

Agency Location:

About Your Agency:

Level of Participation

Participation Explanation:

Choose One:

Main Contact Person/CEO/ED:

WACF is composed of four divisions:

Choose one or more (if applicable) and enter the required information. If you are a Supporting Organization this does not apply. Please skip to the Form Submitter section below.

Division Explanation:

Choose applicable division(s)

Form Submitter:

Agency Location:

About Your Agency:

Level of Participation

Participation Explanation:

Choose One:

Main Contact Person/CEO/ED:

WACF is composed of four divisions:

Choose one or more (if applicable) and enter the required information. If you are a Supporting Organization this does not apply. Please skip to the Form Submitter section below.

Division Explanation:

Choose applicable division(s)

Form Submitter: