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Last Update: 08/03/2009

Even Start Family Literacy Standard Forms

Set A

(These forms must be used, by all sites for all newly enrolled families, unless you are entering this information directly into the Even Start Database.)

Set B

(These forms must be used, by all sites, if there is a need to gather the information therein.)

Agreement of Servicesword file Collaborator-Partner In-Kind Recordexcel file
Collaborator Agreementword file Compliance Reportword file
Criteria for Eligibilityword file Consent for Release of Informationword file
Documentation of In-Kindexcel file Contact and Recruitment Logword file
Family Assessmentword file Contact Recordword file
Family Enrollment - Intake Formexcel file new Home Based Visit Scheduleword file
Family Goals Setting Formword file Individual Weekly Participation Reportexcel file
Family Recruitment Eligibility and Waiting List Scoring Scaleexcel file Informed Consentword file
Home Visit Satisfaction Surveyword file Integrated Classroom Lesson Plan - Monthlyword file
Home Visitor Assessmentword file Meeting Minutes Formword file
Home Visitor Sign-In Sheetword file Monthly Report Summaryword file
Individual Education Planword file Parent Education Satisfaction Surveyword file
Individual Weekly Participation Reportexcel file new Parent Meeting Evaluation Formword file
Media Releaseword file Parent Meeting Sign-In Sheetword filenew
Parent Survey for Parent Meeting Topics word file Participant Referrals Formword file
Partnership-Collaborator Release Form word file Participant Satisfaction Surveyword file
Recruitment Letterword file Recruitment Activity and Contact Logword filenew
Required Enrollment Documentsword file Recruitment Formword file
Safety Policy Regarding Release and Transportation of Childrenword file Referral Formword file
Staff Needs Assessmentword file
Staff Rating of Parent and Child Interactionexcel file
Verification of Incomeword file
Welcome to the Even Start Program Noteword file

Contact Information

Tabatha Siddiqi, State Coordinator Even Start Family Literacy
710 James Robertson Pkwy
Andrew Johnson Tower
9th Floor
Nashville, TN 37243
Phone: (615) 532-6310
Fax: (615) 532-4989