For all Technical Assistance requests please email this request to both Brandi Monts at WISE, and Acacia McGuire Anderson at EF/DHS, , no fewer than 21 days prior to the requested technical assistance start date. Funding for each request will not exceed $3600. Request date: EF Team making request: Business/Agency/Administration ___________ Contact person: Phone: Email: Requested Technical assistance (TA) start date: Estimated TA end date: Please answer the following in detail: What is the TA you are requesting? Are you requesting a specific consultant? Yes No Consultant name: Phone: Email: Website: Why this particular consultant? Why is this TA needed? What actions, if any, have you explored prior to making this request? What do you hope to accomplish as a result of this TA? How will this TA assist your team to meet it’s annual goals? Can this TA be offered to other stakeholders beyond the local EF Team? Yes No Explain: Comments: ____________________________________________________________________________ WISE Use: What is the cost to provide this TA? $ Budget: DHS Use Approved Approved with conditions: Not Approved Reason:
For all Technical Assistance requests please email this request to both Brandi Monts at WISE, and Acacia McGuire Anderson at EF/DHS, , no fewer than 21 days prior to the requested technical assistance start date. Funding for each request will not exceed $3600. Request date: EF Team making request: Business/Agency/Administration ___________ Contact person: Phone: Email: Requested Technical assistance (TA) start date: Estimated TA end date: Please answer the following in detail: What is the TA you are requesting? Are you requesting a specific consultant? Yes No Consultant name: Phone: Email: Website: Why this particular consultant? Why is this TA needed? What actions, if any, have you explored prior to making this request? What do you hope to accomplish as a result of this TA? How will this TA assist your team to meet it’s annual goals? Can this TA be offered to other stakeholders beyond the local EF Team? Yes No Explain: Comments: ____________________________________________________________________________ WISE Use: What is the cost to provide this TA? $ Budget: DHS Use Approved Approved with conditions: Not Approved Reason:
2015-16%20OR%20TA%20Request%20Form%20(5).docx