Technical Assistance & Training Request Form Question Title * 1. First and Last Name Question Title * 2. Organization/Academic Institution (if any) Question Title * 3. Position/Role (if any) Question Title * 4. Please provide your email address. Question Title * 5. Please provide your phone number. Question Title * 6. Are you a student? Yes No If yes, what program? Question Title * 7. Is your request for assistance related to a thesis or dissertation? Yes No Question Title * 8. Are you an older adult? Yes No Question Title * 9. What is your research focus area? Question Title * 10. Do you currently engage older adults or other stakeholders in your research? Yes No I’m not sure If yes, please explain how. Question Title * 11. Please describe any obstacles or challenges you face with stakeholder engagement in research. Question Title * 12. Briefly describe the type of assistance or training you feel may be needed. Question Title * 13. Below, we list common focus areas of technical assistance and training. Please let us know if any of these topics may pertain to your needs. Check all that apply. Understanding the challenges and benefits of stakeholder engagement. Understanding key elements of stakeholder engagement. Developing a proposal that includes stakeholder engagement in research. Identifying and outreaching to stakeholders. Developing and implementing a research advisory group or committee. Creating orientation or training materials for stakeholders. Working with stakeholders as co-principal investigators. None of the above. Other (please specify) Question Title * 14. How did you hear about this technical assistance/training opportunity? Done