Please check the box next to the following questions if the answer is 'yes'.
Please enter the applicable Event Date if there is an Event associated with this TTA.
When entering an Event Date, the Time is also required.
If the TTA is targeted to a particular audience or location, please complete the questions below.
Milestones are an element, activity, work product, or key task associated with completing the TTA (e.g. kick-off meeting, collect data from stake holders, deliver initial data analysis).
Please complete the fields below, if applicable, to create a milestone for this TTA.
1. 1/12: Call with IMPACTS Project Coordinator (OHA), IMPACTS Analyst (CJC) to discuss grantee program implementation and technical assistance needs (Organizations – 2: Participants – 2).
2. 1/15: Call with Executive Director (Criminal Justice Commission, IMPACTS Co-Chair) to discuss program implementation and grantee reporting (Organizations – 1: Participants – 1).
3. 1/19: Call with Manager (Behavioral Health at Klamath Tribal Health & Family Services) and IMPACTS Analyst (CJC) to discuss grantee program implementation and reporting (Organizations – 2: Participants – 2).
4. 1/19: Call with Director (Human Services – Cow Creek Tribe), Social Services Intensive Care Coordinator (Human Services – Cow Creek Tribe), and IMPACTS Analyst (CJC) to discuss grantee program implementation and reporting (Organizations – 2: Participants – 3).
5. 1/26: Call with IMPACTS Project Coordinator (OHA) and IMPACTS Analyst (CJC) to discuss grantee program implementation and upcoming GRC meeting (Organizations – 2: Participants – 2).
6. 1/28: Call with IMPACTS Project Coordinator *OHA) and Tribal Affairs Director (Oregon Health Authority) to discuss tribal government grantee technical assistance. (Organizations – 1: Participants – 2).
Please respond to the Performance Metrics below. The Performance Metrics questions are based on the TTA Type indicated in the General Information section of the TTA.
Please submit a signed letter of support from your agency’s executive or other senior staff member. The letter can be emailed to or uploaded with this request. The letter should be submitted on official letterhead and include the following information:
- General information regarding the request for TTA services, i.e., the who, what, where, when, and why.
- The organizational and/or community needs specific to the request for TTA services.
- The benefits or anticipated outcomes from the receipt of TTA services.
By submitting this application to BJA NTTAC, I understand that upon approval of this application for TTA, the requestor agrees to keep BJA NTTAC informed of any circumstances that may impact the delivery of the TTA, including changes in the date of the event, event cancellation, or difficulties communicating with the assigned TTA provider.
Please call [site:phone] if you need further assistance completing this application.