Technical Assistance For Native Nations

Thank you for your interest in working with the New England Environmental Justice Thriving Communities Technical Assistance Center (EJ TCTAC). To request technical assistance, please complete the following form. It should take about 10-15 minutes to complete. One of our outreach staff will connect with you within a week to schedule an intake call and learn more about your request.

If you would like to complete this form offline, please access our technical assistance request intake form template at the link below and email the completed form to environmental-justice@uconn.edu.

Native Nations Technical Assistance Request Form
Native Nations Technical Assistance Request Form

Part 1: About You & Your Organization

Name(Required)

First Last

Email(Required)

Enter Email Confirm Email

Phone(Required)

Your organization/business name or community affiliation

Write N/A if not applicable

Professional Title

Website

Write N/A if not applicable.

Which of the following best describes your business/organization?(Required)

Federally Recognized Tribe

State Recognized Tribe

Tribal Government

Intertribal Consortia

Native American Organization (includes nonprofits, cooperatives, corporations, and partnerships)

Other

Select all that apply.

Preferred Method of Communication(Required)

Telephone

Part 2 – About Your Community

Please provide the following socio-demographic information for the impacted community or communities for which you are seeking technical assistance.

Name & Location of Native Nation

Please describe the groups that represent your community(race, ethnicity, religion, age, disability, income, etc.)(Required)

What are the primary languages spoken by the community?(Required)

What is the approximate population of the community?(Required)

Provide a brief description of the energy or environmental justice issue faced by the community(Required)

Describe the previous actions taken by you or other individuals or groups to address these issues(Required)

Describe the type of support you hope to receive from New England EJ TCTAC (educational training, grant support, communication services, etc.)(Required)

Please provide any additional comments you would like for us to consider or know

Comments

This field is for validation purposes and should be left unchanged.