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Technical Assistance Request Form
Interested in receiving technical assistance (TA) from the CJNY?
Organization Name *
Your answer
Contact Name *
Your answer
Phone Number *
Your answer
Email *
Your answer
Address
Your answer
What kind of TA are you requesting?
What Group
Only reply if you selected If Peer to Peer TA
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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