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Division of Children, Youth & Families – Child Protective Services

Arrange a PVVCPS Residency at Your Site

Are you interested in arranging a residency at your site or would you like to request more information?  Please fill out the following form and we will contact you as soon as possible.  Thank you.

Organization Name
Organization Address
City
Zip
State  

Individual submitting request

Phone number
Email
Preferred means of communication

Number of Youth participants

Number of Staff participants

Desired residency time and duration

Will your organization seek funding or will you want to work with us to secure funding?

What goals do you wish to accomplish with this residency?

How will your organization celebrate and use the piece?

 
   
   

 

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