Online Technical Assistance Application Form
 For SIG Grantees
If you are not a SIG grantee and would like to receive technical assistance,
please visit www.ca-cpi.org or contact the CARS office to identify additional TA opportunities.

Please submit completed application four weeks prior to proposed training date.

Notice: The online forms for the SIG TA Application and Workshop Registration are currently down. If you would like to make a TA request or register for a workshop, please download an application and fax it into our office at (916) 983-5738.
 

Applicant Information

Contact Person:

Title:

County:

Program Title:

Phone:

 ex. 707-568-3800

Fax:

 ex. 707-568-3810

Email:

Technical Assistance Information

1) What kind of assistance is needed? (Check all that apply)
    Training     Consultation     Other

    Please describe:

2) Please identify the primary goal(s) to be achieved through the requested technical assistance or training.

Goal:

Outcomes:

1)

 

2)

 

3)

3) Which of the following is your preferred format to receive technical assistance/training?
     On-site     Other off-site location     Conference Call     Other

4) Proposed training date(s):

5) Estimated number of participants:

6) Would you like to request a specific consultant or consultants?
     Yes     No       If yes, please specify: