Is your SCOR notebook up to 21 date? Do you have current copies of 22 IFSP/IEP or 504s? Does the current school district provide any assistive technology 23 services, devices or specialty adaptive equipment to your EFM? Does the gaining school district 24 have the current IFSP/IEP or 504? Services Question Please choose If yes please comment Is your EFM receiving 25 Supplemental Security Income (SSI)? Have you submitted a change of 26 address for SSI payments? Is your EFM receiving 27 Medicaid? Do you need information on 28 applying for Medicaid at your new location? Is your family receiving 29 WIC/Food Stamps? Care Please choose If yes please comment Question Do your child(ren) need a child 30 care provider? Will your child(ren) be 31 participating in the Child, Youth & Teen Program (CYTP)? Please return completed form to your EFMP Family Case Worker. Questions? Contact your EFMP Family Case Worker at 703-693-4172/6510. Exceptional Family Member Program, Henderson Hall Marine & Family Programs, Bldg. 12, 1555 Southgate Rd., Arlington, VA 22214 Email: Website:
21 Is your SCOR notebook up to date? 22 Do you have current copies of IFSP/IEP or 504s? 23 Does the current school district provide any assistive technology services, devices or specialty adaptive equipment to your EFM? 24 Does the gaining school district have the current IFSP/IEP or 504? Services Question Please choose If yes please comment 25 Is your EFM receiving Supplemental Security Income (SSI)? 26 Have you submitted a change of address for SSI payments? 27 Is your EFM receiving Medicaid? 28 Do you need information on applying for Medicaid at your new location? 29 Is your family receiving WIC/Food Stamps? Care Question Please choose If yes please comment 30 Do your child(ren) need a child care provider? 31 Will your child(ren) be participating in the Child, Youth & Teen Program (CYTP)? Please return completed form to your EFMP Family Case Worker. Questions? Contact your EFMP Family Case Worker at 703-693-4172/6510. Exceptional Family Member Program, Henderson Hall Marine & Family Programs, Bldg. 12, 1555 Southgate Rd., Arlington, VA 22214 Email: Website: