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Technical Assistance Request Form
Interested in receiving technical assistance (TA) from the CJNY?
Organization Name *
Contact Name *
Phone Number *
Email *
Address
What kind of TA are you requesting?
Clear selection
What Group
Only reply if you selected If Peer to Peer TA
Clear selection
What area of TA are you requesting? *
*Please refer to the link below to see what is included in each category. http://www.communityjusticenetworkforyouth.org/technical-assistance/#types
Notes
Next Steps, Follow Up
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