Inclusive Network of Kansas

Request Field Based Technical Assistance Online

Please submit your request for technical assistance by completeing this online form or you may request a paper application by writing oboldgea@ku.edu

Agency Name or USD:
Person Making Request:
Position:
Name of School:
Address:
City:
State:
Zip:
Phone:
Fax:
Email:
Preferred Method of Contact:
List team members (and roles) who will participate in the technical assistance activities. Please inform other team members, including the student’s parents, that you are requesting technical assistance

Describe the type of help you are requesting

Describe the desired outcome

Describe your school setting and the grade level(s)

When would you like the assistance? (Preferred dates, times, lengths, etc.)