Request for Assistance

Please note: The Mid-Atlantic Equity Center is funded to provide training and technical assistance to Delaware, DC , Maryland, Pennsylvania, Virginia and West Virginia. Unfortunately, we are unable to accommodate requests for assistance outside of this service region. To access information about the Equity Center that serves your region, visit http://www.ed.gov/about/contacts/gen/othersites/equity.html

I am interested in receiving assistance from the Equity Center. Please contact me at the following address:

*required field

* Name:
*School/District:
*Address:
Address2:
*City:
*State	* ZIP:
*Phone:
* E-mail:

I am interested in the following type(s) of assistance within the areas as checked below

Assistance area (check all that apply)
Access to High Quality Teachers for All Students
Access to High Quality Instructional Programs for English Language Learners (ELLs)
Appropriate Representation of Low-income and Minority Students in Special Education and Gifted and Talented Programs
Dropout Prevention and Reentry
Other

Assistance types (check all that apply)

Technical assistance
Professional development training
Resources and information on equity-related topics
Other :

Assistance objectives

Please write in your objective :

Once we have received your request for assistance, an Equity Center staff member will contact you to discuss next steps. We look forward to working with you.

You may also print this form and mail or fax to:

Gail Sunderman, Director
Mid-Atlantic Equity Center (MAEC)
The George Washington University Center for Equity and Excellence in Education
1555 Wilson Blvd., Suite 515
Arlington, Virginia 22209
Phone: (703) 528-3588 Fax: (703) 528-5973