Community and Parent Advisory Group Application

Please provide the information below. Information provided on this form may only be shared with others for the purpose(s) of the administration of the child support program and other related programs [Wis. Statutes, § 49.83].

Contact Information

Are you enrolled in Safe at Home program?
What is the best method to contact you?


Have you reviewed the Community and Parent Advisory Group informational materials or participated in an information gathering session?
Would you prefer virtual attendance?


The Community and Parent Advisory Group will meet four times per year for two hours. We will make every effort to accommodate your schedule. 

Please check all the times you are available.


What accommodations will you need assistance with in order to participate?

Demographic Information

The Wisconsin Department of Children and Families (DCF) does not discriminate against any individual or group because of race, religion, age, national origin, color, height, weight, marital status, genetic information, sex, sexual orientation, gender identity or expression, political beliefs, or disability.

Our goal is to select parents and guardians who are representative of the Wisconsin caseload in as many demographic areas as possible. We want the Community and Parent Advisory Group to be inclusive and diverse. You can help by providing the information below. Please provide only the information you are comfortable sharing.

All levels of education are welcomed and valued.
Annual Household Income
Are you a member of the LGBTQIA+ community?
Are you a parent who pays child support?
Are you a parent who receives (or is supposed to receive) child support?
Are you a parent with primary placement of your child?
Are you the biological parent of the child(ren) you care for?
Do you have a child support case being handled by a county or tribal child support agency?

Personal information you provide may be used for secondary purposes [Privacy Law, s. 15.04(1)(m), Wisconsin Statutes].

DCF-F-5657-E (N. 08/2023)