Request edit access
African American Family Preservation & Prevention Services Pre- Application
The African American Preservation Grant: Family Preservation Grant, administered by the MN Department of Child, Youth, and Families, aims to deliver child abuse prevention strategies and support the well-being of African American families. This grant focuses on providing comprehensive support services through advocacy and in-home visiting support, fostering community engagement, and ensuring access to culturally specific resources.

Eligibility Criteria

  1. Residency:

    • Must be a resident of Minnesota.
    • Proof of residency required (e.g., utility bill, lease agreement).

  2. Family Composition:

    • Must be a Black or African American family.
    • Must be a single parent, young parents, and families with children.

  3. Income Level:

    • Must meet income guidelines based on family size.
    • Proof of income required (e.g., pay stubs, tax returns).

  4. Current Living Situation:

    • Must be experiencing housing instability or at risk of homelessness.
    • Includes renting, staying with family/friends, or in a shelter.

  5. Commitment to Program Participation:

    • Must be willing to participate in in-home parenting support, community engagement activities, and holistic wellness programs.
    • Commitment to attending scheduled sessions and classes.


Email *
Full Name  *
Preferred Pronouns  *
Today's Date  *
MM
/
DD
/
YYYY
Address *
What is your race?  *
I am able to agree to the following program qualifications:

Residency: Must be a resident of Minnesota.

Family Composition: Must be a Black or African American family.

Income Level: Must meet income guidelines based on family size. 
Must be a single parent, young parents, and families with children.

Current Living Situation: Must be experiencing housing instability or at risk of homelessness.

Commitment to Program Participation: Commitment to Program Participation:

- Must be willing to participate in in-home parenting support, community engagement activities, and holistic wellness programs.
- Commitment to attending scheduled sessions and classes.
- Agree to work with family mentor and activities coordinator.
- Attend our educational events
 *
Date of Birth (month, date, year) *
MM
/
DD
/
YYYY
Phone Number *
Email *
Preferred Method of Contact:
 *
Required
Next
Clear form
Never submit passwords through Google Forms.
This form was created inside of Divine Konnections Inc..

Does this form look suspicious? Report

Google Forms