New York State Coalition Against Sexual Assault
The Sexual Assault Demonstration Initiative Application

Provide your contact information

Question Title

* 1. Provide your contact information.

Organization *

Address *

Address 2

City/Town *

State/Province *

ZIP/Postal Code *

Question Title

* 2. County(ies) Covered

Question Title

* 3. My organization is interested in participating in the following cohort(s)

strengthening sexual assault services and outreach

fortifying sexual violence prevention activities

mitigating vicarious trauma in professionals addressing sexual assault

4. Provide frontline staff contact information for the cohort(s) for which you are applying.

Question Title

* A. Cohort A (SA services)

Name

Title

Phone

Question Title

* B. Cohort B (SV prevention)

Name

Title

Phone

Question Title

* C. Cohort C (vicarious trauma)

Name

Title

Phone

5. Provide leadership staff contact information for the cohort(s) for which you are applying.

Question Title

* A. Cohort A (SA services)

Name

Title

Phone

Question Title

* B. Cohort B (SV prevention)

Name

Title

Phone

Question Title

* C. Cohort C (vicarious trauma)

Name

Title

Phone

New York State Coalition Against Sexual AssaultThe Sexual Assault Demonstration Initiative Application

Provide your contact information

Question Title

* 1. Provide your contact information.

Question Title

* 2. County(ies) Covered

Question Title

* 3. My organization is interested in participating in the following cohort(s)

Question Title

* A. Cohort A (SA services)

Question Title

* B. Cohort B (SV prevention)

Question Title

* C. Cohort C (vicarious trauma)

Question Title

* A. Cohort A (SA services)

Question Title

* B. Cohort B (SV prevention)

Question Title

* C. Cohort C (vicarious trauma)

New York State Coalition Against Sexual Assault
The Sexual Assault Demonstration Initiative Application