RIPRC TA Request Form
This form is intended for use by prevention providers.
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Your organization/coalition/task force name: *
Your name: *
Your email: *
Who are you requesting this TA for? *
Is this an individual or group TA request? *
Of the options below,  which best describes how you envision this TA unfolding? (note: this may change) *
Which best describes your role in your organization?
Describe the TA you, your staff, or your organization is requesting. If you are unsure, please describe the challenge you or your organization is facing. *
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