Technical Assistance Services Request Form

Note:   This form is only to be submitted by tribal organizations looking to develop tribal justice systems or by existing tribal justice systems.  We do not provide technical assistance or legal services to individuals.

Please complete the following form. Text boxes with red arrows (  - ) indicate fields that must completed before you can send your information. When you have completed making your entries into the form, please click "Submit Request Form" on the bottom of this page to send your Technical Assistance Services Request to our staff.

1.  Requestor.  Please indicate the name of the court/organization requesting technical assistance services.
Name of Court/Organization:  -
Mailing Address:  -
Telephone:  -
Fax:  -
E-Mail Address:  -
 

2.  Primary Contact. Please indicate the name of the individual that should be contacted regarding this request.  This person will be contacted for scheduling and coordination of the on-site visit, provide background information, and basically serve as the primary contact for all communications with the Resource Center.

Name of Contact Person:  -
Mailing Address:  -
Telephone:  -
Fax:  -
E-Mail Address:  -
 

3.  Bureau of Justice Assistance Grantee Status.  Please indicate whether your tribal justice system or organization is the recipient of a current BJA Tribal Justice grant.

 -   BJA Grant Recipient? Yes        No  
If yes, please answer the following:

Grant Number:  

Start Date:  

 

Type of Grant: Planning  Enhancement    Implementation

End Date: 

 

4.  Technical Assistance Requested.     Please briefly describe the type of assistance requested.

 -     a.  List the primary objectives you would like to accomplish with Technical Assistance from the Resource Center.
 

 -     b. List the desired outcomes and/or products from an on-site technical assistance visit.

 

 -   5.  Background Information.  Please provide a brief, descriptive summary of your court or organization including:  administrative information, service population and/or jurisdiction(s), and describe obstacles and barriers encountered (if any).  (Be prepared to send copies of grant application, feasibility studies, progress reports, etc.)

 

 -   6.  Technical Assistance Location and Timelines.  Please provide information regarding when you would like technical assistance services provided (please pick several dates) and where you would like assistance provided (location, including building, city and state).  Note:  Select dates that do not conflict with your organization�s or staff�s planned holidays, ceremonies, trainings, vacations, etc.