Rest of State 21 CCLC Technical Assistance Request
Rest of State Subgrantees,

Please complete this short form to request any techinal assistance that you may need, including but not limited to: reaching target enrollment, providing engaging in-person activities, inputting data in EZReports, and/or building strong partnerships. We are here to assist you in providing quality programming.

Please fill out this Google Form if you need support in any area that may require a technical assistance visit or call. Thank you!
Sign in to Google to save your progress. Learn more
Email *
Your Name *
Your Role *
Lead Agency *
Project Number (Last 4 digits) *
Describe what assistance is needed: (Be as specific as possible) *
Preferred platform *
We thank you for reaching out to the Rest of State Resource Center. Should you need emergency assistance, please contact the Rest of State Technical Assistance Resource Center at ny21cclc@binghamton.edu or you can call us at 607-777-9240.
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Binghamton University.

Does this form look suspicious? Report