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Minnesota Prevention Resource Center Technical Assistance Request
Please complete the following questions as best as you can. An MPRC staff will be in contact with you shortly.
If you have any questions, please contact Kara Skahen at kara@ansrmn.org
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Name
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Your answer
Email
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Your answer
County in Minnesota
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Your answer
Name of your Organization
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Your answer
Type of Funding
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Choose
PCN
DFC
SPF-PFS
SPF-Rx
TFC
SHIP
Other (please specify below)
Please describe your technical assistance request in as much detail as you can.
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Your answer
Please describe your anticipated timeline for this request or any deadlines. MPRC will take this information into consideration. *individual timelines vary based on request workload.
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Your answer
The information requested from MPRC is intended to serve:
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An individual
A population (ex. coalition, non-profit organization)
Other:
Describe the target audience your technical assistance request is intended to serve. Please be as specific as possible (ex. Hmong youth ages 14-18, reside in Hennepin County)
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Your answer
How will this request benefit the target audience?
Your answer
Is there anything else you would like us to know?
Your answer
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