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NCDB Intensive Systems TA Intake Form

Introduction

This form is for state deaf-blind projects interested in intensive systems TA from NCDB to describe their needs and request support. If you have questions, contact the lead for the relevant initiative:
  • Family Engagement - Jana Villemez (jvillemez@helenkeller.org)
  • Identification and Referral - Emma Nelson (enelson@helenkeller.org)
  • Interveners and Qualified Personnel - Kristi Probst (kprobst@helenkeller.org)
  • Transition - Mike Fagbemi (mfagbemi@helenkeller.org)
We recommend that you complete a Word version of the form prior to filling out the online version, as you may need time to find the necessary information and consult with other project staff.
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