Family Services / All Forms

55 PLUS Program Application Form Form required to apply for the 55 PLUS Program. To be completed by the applicant.
Access to Birth Records The Access to Birth Records form allows you to apply for access to birth records related to adoption which you may be eligible to receive.
Adult Abuse Registry The Adult Abuse Registry helps protect vulnerable adults by allowing employers to screen potential employees and volunteers who will work with adults specified as vulnerable under The Adult Abuse Registry Act or related laws and regulations.
Application for Continuation of Placement of a Vulnerable Person in a Developmental Centre Under The Vulnerable Persons Living with a Mental Disability Act, certain requirements must be met before a substitute decision maker for a vulnerable person can be appointed. Use this form to apply for continuation of placement in a developmental centre.
Application for Temporary Placement of a Vulnerable Person in a Developmental Centre for Respite Care Under The Vulnerable Persons Living with a Mental Disability Act, certain requirements must be met before a substitute decision maker for a vulnerable person can be appointed. Use this form to apply for temporary placement.
Application for the Appointment of a Substitute Decision Maker Under The Vulnerable Persons Living with a Mental Disability Act, certain requirements must be met before a substitute decision maker for a vulnerable person can be appointed. Use this form to apply for substitution of a decision maker. The requirements for a substitute are included in this application.
Application for the Appointment of a Substitute Decision Maker for Property for a Person Residing Outside of Manitoba Under The Vulnerable Persons Living with a Mental Disability Act, certain requirements must be met before a substitute decision maker for a vulnerable person can be appointed. Use this form to apply for appointment as substitute decision maker.
BUILDINGFoundations Bursary Application You may be eligible for a Manitoba Housing bursary if you are a post secondary student (including mature students and graduate students) living in a subsidized rental housing unit in Manitoba or if you are receiving a rental subsidy funded by Manitoba Housing. Use this form to apply for the bursary.
Child Abuse Registry Child Abuse Registry checks are required for people who want to provide services to or work for a child and family services agency, an adoption agency, a day care centre or a nursery school. Applicants for many other types of jobs and volunteer positions with access to children will require a registry check, too. Any adult who wants to foster or adopt a child, and any adult who will live with them, must be screened by the registry. If you are asked to provide a Child Abuse Registry check for yourself, use this form to apply for it.
Child Care Centres Pension Plan Contribution: Prepayment Application Form The program provides financial support to child care centres by processing pre-payment of a child care centre's employer contribution cost for the quarter.  This is to ensure that funds are available to make payments to pension plan provider.
Child Care Centres Pension Plan Contribution: Reimbursement Application Form The program reimburses up to 4% of employer pension contributions.  All employees are eligible to join the pension plan as soon as it is set up.  For-profit child care centres are not eligible for funding.
Child Care Subsidy The Child Care Subsidy Program provides provincial support to eligible families to help with the cost of care by reducing child care fees for children from the ages of 12 weeks to 12 years. Complete and submit the online application to determine eligibility for the program.
Child Care Workers and home-based Providers Retirement Benefit Form used to apply for a one-time payment of a retirement benefit to people who work in a Manitoba based non profit centre, Nursery School or licensed family or group child care home. Must meet eligibility requirements.
Child Care Workers and home-based Providers: RRSP Contribution Reimbursement Application Form The program reimburses 50% of RRSP contributions up to a set maximum to help support family and group child care providers save for retirement. Inclusion Support staff are also eligible.  Participation is voluntary.
Children's Opti-Care Program Claim Form Form required to request funds for Children's Opti-Care Program to pay some of the cost for their children's glasses. Must be completed by the patient's parent or guardian and an eye doctor or optician.
Consent for Consideration of Appointment as Emergency/Temporary Substitute Decision Maker Under The Vulnerable Persons Living with a Mental Disability Act, certain requirements must be met before a substitute decision maker for the vulnerable person can be appointed. Use this form (schedule B to E) to apply for appointment as emergency/temporary substitute decision maker.
Contact Preference A Contact Preference specifies the type of contact, if any, between a birth parent and adoptee.
Contact Veto/Preference Cancellation A Contact Veto/Preference Cancellation cancels your previously filed Contact Veto or Contact Preference from the Manitoba Post-Adoption Registry.
Critical Incident Report As of October 15, 2015, The Child and Family Services Amendment Act (Critical Incident Reporting) is in force and it is mandatory to immediately report critical incidents, including serious injury or death, involving children in care.
Disclosure Veto A Disclosure Veto prohibits disclosing information identifying the person who filed the veto.
Disclosure Veto Cancellation The Manitoba Post-Adoption Registry will cancel your previously filed Disclosure Veto from the Manitoba Post-Adoption Registry.
Early Childhood Education: Tuition Support Conditional Grant Application Form used by individuals(student) to apply for conditional grant to cover a portion of the tuition costs of a two or three year Early Childhood Education (ECE) diploma program at a recognized Manitoba College. Must meet eligibility requirements.
Early Learning and Child Care Licence Application Application form completed and submitted to Early Learning and Child Care Program whereby a perspective licensee(s) applies to become licensed and declares the type of facility they wish to operate, the ages and number of children to be cared for in either a child care centre, nursery school or home based program.
Early Learning and Child Care Program: Centre - Age Exemption Request Form Fillable age exemption request form that licensed child care facilities use to request age exemptions to meet the needs of families requiring childcare.
Early Learning and Child Care Program: Family and Group Child Care Homes Kindergarten Child as School Age Child - Age Exemption Request Form Fillable age exemption request form that licensed home based child care providers complete to have a kindergarten child considered a school age child.
Early Learning and Child Care: Family Child Care Home Personal Reference Two personal reference checks must be completed and submitted to Early Learning and Child Care Program for each licencee in a home based child care program by individuals who have observed the licensee caring for children. 
Early Learning and Child Care: Record of Child Care Residents/Staff for Licensed Family/Group Child Care Homes home (when applicable). This record must be updated when there are any new residents, licensees, overnight or support staff in the home.
Emergency Application for the Appointment of a Substitute Decision Maker Under The Vulnerable Persons Living with a Mental Disability Act, certain requirements must be met before a substitute decision maker for the vulnerable person can be appointed. Use this form to apply for an emergency appointment for a substitute.
Housing Rental Application and Guide Use this form to apply for subsidized housing with Manitoba Housing. A guide is included in the application.
Inclusion Support Program: Staffing Grant Payment Form The staffing Grant Payment Form reports the children's attendance and salary and benefits paid under the Inclusion Support Program. The child care facility completes this form every four week billing to claim approved grant funding under the program.  
Interjurisdictional Support Orders (ISO): Form A.2 - Support Variation Application All ISO applications must include either Form A.1 or A.2. Form A.2 is required for all applications where there is a change requested from a support order or written support agreement. This form sets out the change to the support order or agreement that is being requested, identification information, legal authority and family history. It is very important to complete this form with as much accurate information as possible as sufficient information is needed to locate and notify the respondent about the proceeding in the other jurisdiction relating to your application. Form A.2 also provides a list of the ISO forms which might be included in your application, as well as other common documents and a space for you to describe other attachments. Form A.2 is the only form in the A-K package which must be sworn or notarized. All other forms and documents are attached to Form A.2 and become part of your Support Variation Application.
Internationally Educated Applicants: Become Classified - Child Care A form for Internationally Educated applicants who wish to work in licensed Early Learning and Child Care in Manitoba.
Manitoba Child Benefit Use this form to apply for the benefit. NOTE: To apply for the Manitoba Child benefit you need to understand the different types of benefits for different types of families.
Manitoba Housing Bursary Fund Donation The BUILDINGFoundations Bursary Fund provides bursaries to post secondary students (including mature students and graduate students) to help them with housing while they are studying in a Manitoba post secondary institution. Use this form to make a tax-deductible donation to the bursary fund to help more Manitoba students succeed in their studies.
Medical Equipment Request and Justification Form The DHSU follows current partner program policies and legislation to determine eligibility for medical supply/equipment and diet requests. All requests must be completed by a health professional.
Medical Supply Request and Justification Form The DHSU follows current partner program policies and legislation to determine eligibility for medical supply/equipment and diet requests. All requests must be completed by a health professional.
Notice of Appeal to the Social Services Appeal Board If you disagree with a decision, you can appeal to the Social Services Appeal Board.  Appeals may be made about decisions for these programs/services: adoption agency licensing, child care licensing and subsidies, 55-plus income supplement, prenatal benefit, income assistance, residential care licensing, marketAbilities program eligibility and vulnerable persons living with a mental disability (eligibility and individual care plan). Use this form to make an appeal.
Online Child Care Registry The Online Child Care Registry helps families find, and apply for a space in licensed Manitoba facilities. Register online to add your child(ren) to one or more wait lists and manage your contact information from one location.
Post-Adoption Registry: Change of Information This form will advise the Manitoba Post-Adoption Registry of your updated contact information
Rent Assist Application Form Form required to apply for the Rent Assist benefit for people who are not receiving EIA benefits. To be completed by the applicant.
Request to Withdraw an Application for Appointment of a Substitute Decision Maker Under The Vulnerable Persons Living with a Mental Disability Act, certain requirements must be met before a substitute decision maker for a vulnerable person can be appointed. Use this form to request withdraw of an application for the appointment of a substitute decision maker.
Review of Substitute Decision Maker Appointment Before Renewal Under The Vulnerable Persons Living with a Mental Disability Act, certain requirements must be met before a substitute decision maker for a vulnerable person can be appointed. Use this form to apply for a review of the appointment before the appointment is renewed.
Schedule A - Real and Personal Property Report Under The Vulnerable Persons Living with a Mental Disability Act, certain requirements must be met before a substitute decision maker for a vulnerable person can be appointed. Use this schedule to list all the real and personal property of a vulnerable person.
Schedule B - Consent for Consideration of Appointment as a Substitute Decision Maker Under The Vulnerable Persons Living with a Mental Disability Act, certain requirements must be met before a substitute decision maker tfor a vulnerable person can be appointed. Use this form to apply for an appointment as substitute decision maker.
School Tax Assistance for Tenants 55 Plus (STAT 55+) Provides rebates to eligible tenants over the age of 55 to offset the school tax portion of rent costs.
Staff Replacement Grant Application Form used by non profit centres and licensed family providers to apply for reimbursement of actual staffing replacement costs (substitute) of an existing CCA or licensed home provider while a workplace student attends an approved ECE workplace program.
Therapeutic Diet and Nutrition Request and Justification Form The DHSU follows current partner program policies and legislation to determine eligibility for medical supply/equipment and diet requests. All requests must be completed by a health professional.
Variation of an Appointment of a Substitute Decision Maker Under The Vulnerable Persons Living with a Mental Disability Act, certain requirements must be met before a substitute decision maker for a vulnerable persnon can be appointed. for an individual. Use this form to apply for a variation of an appointment of a substitute decision maker.
Wheelchair Seating Component Request and Justification Form Form required to request for wheelchair seating and components through the DHSU. All requests must be completed by an occupational therapist.
Browse Results:
1