NC Office of Violence Prevention Technical Assistance Request Form

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Use the form below to submit a request for technical assistance. Once our office receives your request, we will follow up to gather further details to create your customized plan.

This form is only for NC-based agencies and organizations. If you are not NC-based and are seeking assistance from our office, please email us directly at ovp@ncdps.gov.

  • Office of Violence Prevention Technical Assistance
  • Complete
Indicates required field
Would you like to add a secondary contact?
Secondary Contact
Organization Information
Sector
What is the primary population your organization serves?
Age Group
Technical Assistance Needs
Please submit one request per Technical Assistance need.
1. What kind of Technical Assistance are you seeking?
What type of data support do you need?
Include intended use of the data, key data points you’re looking for, and any other relevant context.
Include background information on your organization, the grant you are seeking, and any partners. 
What type of program development/implementation support do you need?
Stages Graphic of program development life cycle that includes plan, develop, implement, update.
Include background information on the program, any challenges in development or implementation, and funders or partners, if applicable. 
Do you already have an evaluation plan?
Include purpose of the evaluation, challenges you’re currently experiencing, and funders or partners, if applicable. 
Provide information about the event audience, anticipated attendance, and the purpose of the event or site visit. 
Location of Speaking Event
Include information about the purpose of the event, intended audience, and presentation topic. 
What subject matter expertise are you seeking?
Include information about the purpose of the request and any specific models or research you want to learn about.  
Include specifics about the partnerships or stakeholders you want to engage, funding purposes, or current challenges you are experiencing.
(We will do our best to respond by your preferred date; however, due to potential fluctuations in capacity, this is not guaranteed.) 
This question is for testing whether or not you are a human