California Community Colleges
Student Mental Health Program (SMHP)
TRAINING AND TECHNICAL ASSISTANCE (TTA) APPLICATION FORM

The purpose of training and technical assistance (TTA) is to build CCC system capacity. In order to achieve this goal, a broad array of consultation or coaching, training, sponsorship, or other development services are available to colleges.

A. APPLICANT INFORMATION (REQUESTING COLLEGE)

First Name*
Last Name*
Title*
Community College*
Address Line 1*
Address Line 2
City*
Zip*
County*
Phone*( ) - Ext:

Email*

B. TECHNICAL ASSISTANCE INFORMATION

2A. What kind of assistance are you requesting? (Check all that apply)*
Facilitation for meeting or event
Keynote Speaker/Presenter
Consultation
Training (from workshop series)
Travel support to present at a training event or conference
Logistical support for planning your own meeting or event
Other
2B. If you selected "Training (from workshop series)" for question 2A above, please select specific trainings from the following list:
Welcome Home for Veterans
LGBTQ
Trauma Informed Care
SBIRT
HIPAA/FERPA
Other
2C. If you selected "Travel support to present at a training event or conference" FOR 2A above, please select specific training from the following list:
Local event
Out of state event
2D. If you selected "Logistical support for planning your own meeting or event" FOR 2A above, please select specific activity from the following list:
Health and wellness activity
Onsite training
Other
3. Do you intend to partner with other organizations, such as:*
Another Community College
4-Year College or University
County Mental Health/MHSA
Community Based Org
Coalition/Community Partnership
Other
4. Approximately how many individuals do you think will participate?*
5. Please identify the geographic area(s) for marketing the event or service.*
Campus
District
Regional
Statewide
County/Local
6. For larger trainings, do you have an appropriate training space on campus or in the community?*
Yes     No    
7. Do you have a proposed timeframe?*
Yes     No    
If yes, when (please provide multiple date possibilities)?
8. Are these TTA services intended to build capacity to meet the mental health needs for any of the following population(s)? Check all that apply.
Gender
Male
Female
Transgendered
Age Group
Young Adults (<21)
Adult
Older Adults/Senior (>30)
Campus Affiliations
Faculty
Staff
Administration
Students
Other
Race/Ethnicity
Asian
Black/African American
American Indian/Native American or Alaskan Native
Hispanic/Latino/Spanish origin
Native Hawaiian/Pacific Islander
Middle Eastern
Other
Other student populations (often un/under-served or at-risk):
LGBTQI2S
Veterans
Youth Formerly in Foster Care
People with Disabilities
Homeless or Near Homeless
Formerly Incarcerated
Older
9. Please provide any other information that would be useful for us to know regarding your request.

An important note about evaluation: CARS is committed to ensuring the integrity, relevance and quality of our services. All TA and training services are evaluated in accordance with our funder.

As a recipient of services, you will be required to complete both initial and follow-up evaluations. You can expect to receive via email an evaluation survey shortly after services are received, and again 60-90 days later.

The Center for Applied Research Solutions (CARS) is responsible for the content of the page, including but not limited to:
Content accuracy, initial vetting of external links, photographs and graphic images (copyright), files, program, and downloadables, libel and defamation.
For questions or comments concerning this website, please contact CARS at (855) 304-1647 or email kdecelle@cars-rp.org.