Technical Assistance Program

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Technical Assistance Request Form

* Required fields
1. Site
Please indicate the agency or agencies requesting technical assistance.
Agency  *
Address  *
 
City  *
State  *
ZIP  *
Phone  *
Fax
Email  *

2. Primary Contact
Indicate who will be the main point of contact for the technical assistance project — the person who will have decisionmaking authority during the project.
Name  *
Title
Agency Affiliation  *
Address  *
 
City  *
State  *
ZIP  *
Phone  *
Fax
Email  *

3. Project Overview
Please describe the nature of your agency's automation/integration project (i.e., upgrade, replacement, integration of multiple systems, etc.)

4. Technical Assistance Requested
Describe the nature of the technical assistance requested from SEARCH in as much detail as possible.

5. Funding
Have you received Federal funding to support this initiative? If so, please describe.

6. Principal objective and anticipated results
Identify the reasons assistance is necessary and what the assistance is intended to accomplish.

7. Project time line
What time lines have been established for the project? (Please provide dates, and any reasons for deadlines, i.e., funding time frames.)

8. Consultants/Contractors
Have other consultants, contractors or systems integrators been involved in this project? If so, explain.

9. SEARCH
How did you hear about the SEARCH Technical Assistance Program?





Is there existing documentation that would assist SEARCH in understanding this project or assist during a site visit, such as grant applications, needs assessments, long and/or short-range plans, committee and/or consultant studies/findings, requests for information or proposals, an agency schematic and/or other informational documents? If so, please send to us via email, fax, or mail.

Email:
Fax:
Address:

(916) 392-8440
SEARCH
7311 Greenhaven Drive, Suite 145
Sacramento, California 95831