Problem Intake Form - Smartsheet.com

Organization: (agency, division, branch)*

Name*

Rank*

Job Title*

E-mail*

Phone Number*

City and State you are based in:*
(Full City Name, State Abbreviation)

Will you be the primary POC?*
Project POC: assigned primary point of contact of this problem who will interface with NSIN.

If not, please provide a Project POC:
(Name, Rank, Email, and Phone)

Supervisor Name, Rank, and Title:*
Someone in your chain of command who supports (or champions) your project with NSIN. This can also include an alternate Project Sponsor.

Supervisor Email:*

Which best describes your project?*

Please describe the Project:*
1. Describe the project background.
2. What is the problem the project seeks to address?
3. Who is impacted and would benefit from a solution? (ex: units, services, contractors, others)
4. What would a solution help you achieve? (Save resources, time, improve lethality, etc.)

Do you have a solution in mind?*

Solution End State:*
(If you receive a solution, what is the desired end state? Please be as detailed as possible: deliverables, knowledge attained, etc.)

If applicable, describe the solution in mind.
What is the minimum improvement or value a solution would need to provide for you to consider it a success? Please be as detailed as possible: deliverables, knowledge attained, etc.

U.S. citizens or permanent residents only?*
Is this a needed status to work on the project?

Skill sets Required?*
Please choose all that apply.

If other, please detail here:

Can this be conducted virtually?*

What resources can you provide?*
Data sets, software licenses, government furnished equipment, funds, access to SMEs, documents, or none.

Can the project POC dedicate 1hr of time per week?*
This time requirement is a minimum that includes check-in meetings, questions, etc. plus any prep time.

Project POC: assigned primary point of contact of this problem who will interface with NSIN.

Solution Implementation:*
NSIN has programs and pathways to help implement solutions. Does your organization also have resources, pathways, or authorities that we should be aware of?(e.g. Funding, ability to implement policy or a concept, etc.)

How did you hear about us?*

Do you have any supporting documentation? If so, please upload below.
Our system is able to handle information up to CUI.

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