TA Request

Healthy Marriage Technical Assistance Request Form

Technical Assistance (TA) is special support that the Office of Family Assistance has contracted with experts to provide to their grantees. Many grantees encounter stumbling blocks or difficulties during the course of program implementation. These experts can serve as consultants to help you think through ways to solve programmatic and evaluative problems. They bring years of healthy marriage and responsible fatherhood program and program evaluation experience to these discussions and provide information and suggestions based on their bird’s eye knowledge of the fields generally. They will work with you to help make your program and its evaluation stronger and more effective.

To request TA, please complete and submit this form. If you need assistance filling out this form, please call (866) 916–4672 or 866–91–NHMRC.

Within 5 business days you will be contacted by a member of the TA Team to schedule a conference call. The call will be used to discuss in more detail your TA needs.

Type of Technical Assistance Requested

Programmatic: (select at least one)

	Domestic Violence
	Faith Based Regulations
	Voluntary Participation
	Marketing
	Participant Outreach and Recruitment
	Participant Retention and Completion
	Staffing and Training
	Project Management
	Curriculum
	Service Delivery
	Other Programmatic TA:

Evaluation: (select all that apply)

	Assessment plans
	Logic Models
	Selecting/Working with a Local Evaluator
	Developing or Reviewing Evaluation Plans
	Tracking Forms and Systems
	Data Management Systems/Automated Data Systems
	Data Collection Methods
	Data Analysis
	Reporting Findings/Forms for Presenting/Reporting Data
	Qualitative Data Collection (Focus Groups and Interviews)
	Using Evaluation Findings for Program Improvement
	Other Evaluation TA:

If you would like to provide additional information about your TA needs, please do so in the space provided.

Grantee: