Form DCF-023 "Educational Statement for a Child of a Foster Care or Adoptive Applicant" - Connecticut

What Is Form DCF-023?

This is a legal form that was released by the Connecticut State Department of Children and Families - a government authority operating within Connecticut. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on June 1, 2017;
  • The latest edition provided by the Connecticut State Department of Children and Families;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form DCF-023 by clicking the link below or browse more documents and templates provided by the Connecticut State Department of Children and Families.

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Download Form DCF-023 "Educational Statement for a Child of a Foster Care or Adoptive Applicant" - Connecticut

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Connecticut Department of Children and Families
EDUCATIONAL STATEMENT FOR A CHILD OF A FOSTER CARE OR ADOPTIVE APPLICANT
DCF-023
6/17 (Rev.)
Page 1 of 2
AUTHORIZATION TO RELEASE CONFIDENTIAL INFORMATION
I hereby authorize
to release to the Department of Children and Families the information
requested below regarding my minor child as required by the Department policies for Probate Court Custodian/Guardian applicants and their child.
Signature of Applicant:
Date:
Address: (No. and Street):
City:
State:
Zip:
INFORMATION ABOUT THE CHILD
LAST Name of Child:
FIRST Name of Child:
Child’s DOB:
Does the above listed child have good attendance?:
Yes
No
If “No,” please describe:
Is the child involved in regular or special education?:
Regular
Special
If “Special Education,” please describe:
Do/Does the child’s parent(s) participate in child’s education, programs, events, etc.?:
Yes
No
If “No,” please comment:
Connecticut Department of Children and Families
EDUCATIONAL STATEMENT FOR A CHILD OF A FOSTER CARE OR ADOPTIVE APPLICANT
DCF-023
6/17 (Rev.)
Page 1 of 2
AUTHORIZATION TO RELEASE CONFIDENTIAL INFORMATION
I hereby authorize
to release to the Department of Children and Families the information
requested below regarding my minor child as required by the Department policies for Probate Court Custodian/Guardian applicants and their child.
Signature of Applicant:
Date:
Address: (No. and Street):
City:
State:
Zip:
INFORMATION ABOUT THE CHILD
LAST Name of Child:
FIRST Name of Child:
Child’s DOB:
Does the above listed child have good attendance?:
Yes
No
If “No,” please describe:
Is the child involved in regular or special education?:
Regular
Special
If “Special Education,” please describe:
Do/Does the child’s parent(s) participate in child’s education, programs, events, etc.?:
Yes
No
If “No,” please comment:
Page 2 of 2
Do you have any concerns regarding abuse and neglect?
Yes
No
If “Yes,” please explain:
Do you have any concerns with this/these parent(s) being licensed as a foster or adoptive family?
Yes
No If “Yes,” please explain:
Additional Comments:
Name of Teacher / Administrator/Social Worker:
Signature:
E-mail address:
Address:
Telephone:
Date:
NOTE: This report should be submitted by the school, teacher or social worker directly to the Department of Children and
Families Office listed below:
ATTENTION: (Name of DCF Social Worker or Administrator):
DCF Office and Address:
Date:
Please Select DCF Office
Page of 2