FLORIDA OUTCOME IMPROVEMENT PROJECT
APPLICATION FOR TECHNICAL ASSISTANCE & TRAINING
Agency Name:
Agency Contact:
Contact E-mail:
Executive Director:
Address Line 1:
Address Line 2:
City:

State:

Zip:

Telephone:

Fax:

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 1.  What are your goals with respect to serving individuals with disabilities?
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 2. Describe present services, types, and severity of disabilities served, number of consumers   served in each employment service you offer, residential services, and other agency services.
 3. What type of technical assistance and training from the Florida Outcome Improvement Project  will assist you in meeting your organizational needs?
Training and Technical Assistance Services (Please check all that apply)
Training & Technical Assistance Needs Assessment
Organizational Change Process (3-4 planning sessions per year)
Leadership Development
Team Development
Strategic Planning
Future Search
Competitive Analysis
Marketing Strategies
Organizational Design Strategies
Focus Group Facilitation & Training
Program Development Services (Please check all that apply)
Person Centered Planning
Self-Determination Training
Job Development Training
Family Involvement Strategies
Job Coaching
Community Integration Strategies
Positive Behavior Support Process
Systems Change Facilitation
Other
 4. What outcomes and benefits do you wish to achieve by participating in the Florida Outcome Improvement Project? 
 5. How did you hear about the Florida Outcome Improvement Project? (Please check all that apply)
ARC/Florida
Florida ARF
Florida APSE
Website
Vocational Rehabilitation
Network Member
Flyer
Other