NYS Youth Justice Institute Request Form

NYS Youth Justice Institute

Request Form

Please complete and submit this form to initiate a request for technical assistance (TA), training, consultation, or press inquiries. A member of the YJI team will contact you for further information. We try to fulfil as many requests as our capacity allows. If we are unable to fulfil your request, we will try to provide suggestions for alternative sources for assistance.

Please provide the following information about the point of contact for this request:

Name:

First NameLast Name

Email

example@example.com

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Organization, Agency, Place of Work:

Role or Job Title:

County or Locality:

Is this request on behalf of a NYS Policy Equity Academy Team?

YesNo

Is this a request for the NYS Youth Justice Peer Advisory Council?

YesNo

Is this a request for the YFACTS Data Center?

YesNo

Is this a press/media inquiry?

YesNo

Is this a request for webinar support?

YesNo

Please describe your request.

Are there funds* allocated to support this request?*

YesNo

If there are any files that would help us respond to your request, please attach them here.

*Funding is not necessarily required for the YJI to agree to fulfil a TA request.