Technical Assistance Request Form

The Indiana Department of Education Office of Special Education supports Local Education Agencies in a variety of areas free of charge. When completing this form, please include as much detail as possible regarding the type and level of support needed. A member of the IDOE team will reach out to the point of contact with next steps based on the details provided. Visit IDOE’s Office of Special Education webpage for additional information.

Name*

First NameLast Name

Title/Position*

Phone Number*

Phone extension (if applicable)

Email Address*

Confirmation Emailexample@example.com

District/Organization*

If you selected 'Other' for District/Organization above, please specify.

School Name (if applicable)

Please select the option that best fits the anticipated need. If unsure, select Technical Assistance*

Workshop/Training - One-time training or supportTechnical Assistance - Ongoing support, which may include training

Description of Need (please be as specific as possible). Do not list any student specific identifiable information such as a name, STN, social security number, or otherwise.*

0/30000

Ideal dates for training/workshop or support to begin (provide a variety of options if possible).

Frequency/Duration (preferred length of support session)

Grades impacted by this experience:*

Early Childhood (Age 3-5)Elementary (K-5)Middle (6-8)High (9-12)