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Washington State SNAP-Ed EvaluationDATA/EVALUATION REQUEST FORMINSTRUCTIONSFill in the below fields. Fields marked with an * must be filled in.Local and implementing agencies should email the completed form to the SNAP-Ed Evaluation Team at SNAPedEvaluation@doh.. Local agencies should CC their IA.The evaluation team will be in touch as soon as possible to confirm your request, but please allow at least three weeks for your request to be completed. Completion times will vary depending on the complexity of your request.If you have any questions about this form, send them to SNAPedEvaluation@doh.Today’s date*: Click here to enter a date.Requester’s Name*: Contact Name (if different then Requester): What agency/organization do you work for?*: Region: Choose an item.Implementing or local agency? Choose an item.Contact Phone*: Contact E-mail*: Data/Evaluation Request Details*: What is the purpose of this request? How will the data/evaluation results be used?*When do you need these results?* Click here to enter a date. ................
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