Wufoo

TAP Team Application

Team Applications are due Ocbober 15, 2008
Purpose: The Technical Assistance Partnership (TAP) Program is an innovative capacity-building project funded by St. Luke’s Health Initiatives, a catalyst for community health. TAP is designed to help coalitions of nonprofit agencies develop the tools and resources they need to resolve critical management and community issues.
Eligible Participants:
- Individuals representing agencies (can include State agencies) that provide health and human services to residents of Maricopa County.
- Coalitions of organizations working on common issues

Contact person for TAP team * Title First Last Suffix
Agency
Your Title
Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Email *
Phone Number * - (###) - ### ####
Suggested Examples of Technical Assistance:

Please select the one category that best describes the type of technical assistance your team is seeking or select "other" and fill in your own description as best you can.
Categories *
Agency Assessment Alliance or Coalition planning Basic Communication Plan Board Development Developing a data base (indicate what type below) Executive Director Round Table Finance and Budgeting Fund Raising - Developing a Plan Fund Raising - Grants Fund Raising - Events and Sponsors Human Resources - Paid Human Resources - Volunteer Public Relations/External Communications Planning - Strategic Planning - Program and Evaluation Other
Please describe "Other" or what type of data base you need to develop.
Proposed Need:

Please answer the following set of questions to describe your team's proposal: your needs and concerns, purpose, proposed approaches and desired outcomes:
We have come together because we all need assistance with: *
We think one approach to meeting our needs would be to: (Optional)
At the end of the project we expect that we would be able to: *
Preferred Meeting logistics

Please indicate the day of the week, time and location your team has agreed to meet. Allow for six two-hour sessions.
Day of the Week *
Monday Tuesday Wednesday Thursday Friday

Select one
Time *
early morning late morning early afternoon late afternoon evening
Preferred general or specific location:
Team Members

Please indicate the name, agency and e-mail address of individuals who have indicated their intent to be members of your team. Members will still need to complete and submit their own profiles.
Teams must be made up of at least five individuals representing at least three different agencies.
1. Name First Last
Agency
Email
2. Name First Last
Agency
Email
3. Name First Last
Agency
Email
4. Name First Last
Agency
Email
5. Name First Last
Agency
Email
6. Name First Last
Agency
Email
7. Name First Last
Email
8. Name First Last
Agency
Email
Thank you for completing the form.

If you have any questions, please feel free to e-mail Bonnie Wright at 602-380-9352 or Bwright30@cox.net.

You will be notified within a month of the closing date whether or not your application has been approved.
Do Not Fill This Out

Wufoo

TAP Team Application

Suggested Examples of Technical Assistance:

Proposed Need:

Preferred Meeting logistics

Team Members

Thank you for completing the form.