Forms

Follow the links below to access each form.

Emergency Assistance Forms

COVID-19 Emergency Assistance Application/Referral Form

Yates County Emergency Funding Form

Employment Related Forms:

Apply for Pro Action Jobs

Senior Community Service Employment Program Form

Summer Youth Employment Application

Program Referral Forms

Yates OFA Referral Form

Community Action Angels Request Form (formerly CHAMP)

Children and Families

Kids on Track Referral Form: Prenatal & Newborn

Kids on Track Referral Form: Child Older Than 3 Months

Family Resource Center Visitation Form

Weatherization/Energy Forms:

Energy Dept. Cooling Program Information Signoff

Weatherization Permission Form for DSS

Energy Dept Permission to Enter Form

Weatherization Questionnaire

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