National Center on Elder Abuse (NCEA)
Training Technical Assistance Request Form 

The REFT Institute, Inc., is serving as a consultant to NCEA through the National Adult Protective Services Association (NAPSA) for technical assistance questions related to training. Funding has been provided by the US Administration on Aging. REFT assistance is offered in the areas of: curriculum development and training for professionals working in state Adult Protective Service programs and State Units on Aging. 

Assistance in these areas will be provided in the form of materials, advice and/or referrals. When appropriate, curricula and training materials in the Center’s training library, which is housed at NAPSA, will be made available. (Note: Duplication and mailing costs may apply.) Each request will be handled on a first-come, first-served basis and will receive a maximum of two hours of technical assistance. Although all requests will be valuable in designing the future of NAPSA’s Technical Assistance service, it may not be possible to fulfill all requests. 

Today's Date (mm/dd/yyyy); for example : 10/25/2006
REQUIRED: DATE with FORMAT mm/dd/yyyy

Response needed by (optional): (mm/dd/yyyy):; for example : 10/25/2006

 

Please choose one of the following four titles that best describes your POSITION:

If, "OTHER", Please specify:

CONTACT INFORMATION

Please provide the following contact information:

First Name
Last Name
Title
Organization
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
FAX
E-mail

Training Background Information

Training purpose:

Training audience (characteristics & number of participants):

Training support (session length; facility size; availability of laptop, VCR, projector, etc.; other):

 

Training Frequency One-Time Training Event

Repeated Event

Training experience (years in field, years as trainer; other):

Training Technical Assistance Request:

Please specify your technical assistance needs with regard to training in the fields of elder abuse or Adult Protective Services. Examples include: curriculum material, adult learning strategies, effective trainer skills, training evaluation, etc. We will address your request in a timely manner. Whether or not we can meet your needs, all requests received will help us identify training needs and shape NCEA and NAPSA’s future training and technical assistance activities. If you are requesting material from the Training Library, please indicate the title of the material.

 

Please press "SUBMIT" only once. If you do not receive a confirmation within a minute or two, then email jeanne@reft.org.

NAPSA and REFT Institute, Inc.
Copyright © 2004 [REFT Institute, Inc.] All rights reserved.
Revised: February 16, 2008