Center
for States Subscription Form
THE
PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13) Public reporting
burden for this collection of information is estimated to average 3
minutes per response, including the time for reviewing instructions,
gathering and maintaining the data needed, and reviewing the
collection of information. An agency may not conduct or sponsor, and
a person is not required to respond to, a collection of information
unless it displays a currently valid OMB control number. The control
number for this project is 0970-0401. The control number expires on
5/31/2021.
Stay connected with the Center for States! Join our email community to stay in touch and in the know about what’s happening at the Center. You’ll receive the latest updates about new resources, services, and events that can help support the work you do with children and families. Your participation is voluntary.
Let us get to know you! Share information about yourself and your work to receive the information that’s most relevant to you. Your privacy is important to us and your personal information will be kept private.
First Name: [Text]
Last Name: [Text]
Email*: [Text]
State or territory: Select [picklist]
What best describes your employer organization? *
State Child Welfare Agency
Territorial Child Welfare Agency
County Child Welfare Agency
Tribal Child Welfare Agency
Private Child Welfare Agency Under Contract for Services
Community-Based Service Provider
College/University
Legal Systems/Courts
Federal Government
Technical Assistance Provider
Other
What best describes your primary area(s) of work responsibility? *
Child Welfare Leadership
Continuous Quality Improvement/Quality Assurance/Data Analysis
CFSR/PIP/CFSP/APSR
Policy Development
Child Welfare Training
Child Welfare Information Systems
Indian Child Welfare Act Implementation
Child Protective Services - Intake
Child Protective Services – Investigation/Assessment
Primary Prevention
In-Home Services
Foster Care – Case Management
Foster Care – Recruitment/Training/Licensing of Resource Families
Foster Care – Independent Living/Youth
Adoption/Guardianship
Youth Leadership/Participation
Family Leadership/Participation
Court Improvement
Legal Representation (of agency, parents, children)
Judicial Decision Making
Social Work Education
Research and Evaluation
Student
Other Area of Child Welfare-Related Work
None of the Above/Not Applicable
What best describes your child welfare agency role?
Senior Level Management
Program Manager/Coordinator
Supervisor
Front-line staff/worker
Student Intern
Family Leader
Other
Not Applicable
We would like your feedback to improve our messaging and service delivery. May we contact you (in 3 to 6 months) to schedule a telephone interview or focus group?
Yes
No
By checking this box, you consent to our data privacy policy.*
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | Pochily, Meredith |
File Modified | 0000-00-00 |
File Created | 2021-01-15 |