INCOME MAINTENANCE PRESENTATION REQUEST

 
Questions regarding this request form should be directed to Carol Cole at colecj@dhfs.state.wi.us.
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1. What are you requesting?
2. If other, please describe.
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3. For which topics are you making this request?
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4. Which agency or organization do you represent?
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5. What type of agency is this?
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6. Is there a specific date by which you need this information?
7. What is the date by which you need this information?
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8. Is this for a specific event?
9. If yes, what is the event?
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10. What is the size ot the intended audience?
11. Is there anything else you feel we should know about this request, your agency, or your event?
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12. How we can contact you? Please give us your name, telephone number, and email address.
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