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Illinois Quality Afterschool Request Technical Assistance Form

If you are an Illinois 21st CCLC grantee with a technical assistance request please complete the form below. For general inquiries and questions please email iqasupport@air.org.

Name:*

First name:

Last name:

Email:*

Phone:

Grantee Name and Cohort Year:*

Program site(s):

What grade-levels does your program serve? (Select all that apply.)

PreK
K-3
4-5
6-8
9-12

Please indicate the level of priority for your request:

High Priority Need - Time Sensitive (less than 3 weeks)
Priority Need - Time Sensitive (4 weeks or more)
General Need
Low Priority Need

Please indicate the category of your request:

Management
Evaluation
Programming
Integrating K-12 and Afterschool
Communication
Collaboration
Other

Please provide details about your request:*

Verification (to prevent automated submissions)
Please enter the sum of 1 and 2:

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