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New Jersey Department of Children and Families Policy Manual




Child Protection & Permanency

Effective Date: 11-14-2016







Revised Date:







CP&P Form 10-10, Voluntary Services Agreement Between the Young Adult (18-21) and the State of New Jersey


Click here to view the Voluntary Services Agreement. CP&P Form 10-10, Between the Young Adult (18-21) and the State of New Jersey.


Click here to view or print this form in Spanish, CP&P Form 10-10(s).




This form is used by the Worker to establish an agreement between Child Protection and Permanency and the young adult ages 18 up to 21 that does not have legal permanence at the time of completing the form and desires to continue receiving services or requested to re-open their case.


This form must be completed and signed by the Worker, and young adult, within one month of his or her reaching the age of 18. For young adults (18-21) already receiving services this form is completed no later than August 5, 2016. This agreement is renewed annually from the date of the young adult’s signature.




The Worker has a face-to-face meeting with the young adult to discuss the form in detail. The Worker reads the form with the young adult in its entirety and answers any questions that may arise prior to the young adult agreeing to the terms in this form.


The Worker will have two copies of the form available. The Worker and young adult sign both copies of the form. The Worker gives one version to the young adult upon completion and the Worker keeps a copy of the agreement for the case file.


The form is divided into three sections. The first section includes the expectations CP&P has regarding the young adult’s responsibilities. The second section includes CP&P’s responsibility towards the young adult and his or her transition to adulthood. The third section is the required signature section that recognizes both parties have agreed to the terms of the form.




After the form is filled out in its entirety, and all questions have been asked and answered, the Worker informs the young adult that if he or she does not abide by the terms of the agreement, that CP&P may close his or her case. Also explain that the young adult’s case can be closed at any time upon his or her request.


My Responsibilities Section of the form:


 Some examples of a high school equivalency program are:

·         General Equivalency Diploma (GED);

·         Educational Testing Services (ETS) high school equivalency test (HiSET); and

·         Test Assessing Secondary Completion (TASC)


NOTE: If a young adult is actively pursuing enrollment into an educational or vocational program, and can show documentation of the same, the young adult will have satisfied the requirement for enrollment.  In addition, if a young adult has recently completed an educational or training program, time should be allotted for them to obtain employment.


Some examples of working towards securing employment are:

·         Participate in a program or activity designed to promote or remove barriers to employment;

·         Applying for jobs;

·         Volunteer work;

·         Internships; or

·         Employment readiness program.


NOTE: A young adult who has experienced trauma or is using substances, may have different needs which require them to focus on their health in order to be able to pursue employment or education.  If a young adult is attending treatment or therapy, and can show documentation of participation, the young adult will have satisfied the productive time requirement.


If a young adult is not fulfilling the expectations laid out in the VSA, or goals outlined in their Transitional Plan for YOUth Success, a case conference with key stakeholders who work with the young adult, or who would be able to provide guidance/suggestions for next steps, must be held before pursuing case closure. The appropriate case conference model will be utilized (e.g., focus on supervision, meeting of the minds, supervisory conference) to ensure that the necessary expertise and insight is present to identify strategies for engagement, re-engagement, and/or planning with the young adult.   




Original          -           Young Adult


Original          -           Case Record