Grant Application Community Grants September 30: For projects starting Oct 1– Feb 28January 30: For projects starting Mar 1– May 30 School Grants November 1: For projects starting Dec 1- Feb 28February 1: For projects starting Mar 1– May 1 APPLICANT INFORMATION Community organization/group School SELECT YOUR NEIGHBOURHOOD Bonne Bay Burgeo/Ramea Corner Book / Bay of Islands Humber Valley / White Bay Port aux Basques Port Saunders Stephenville / Bay St. George CONTACT PERSON #1 CONTACT PERSON #2 PROJECT NAME WELLNESS PRIORITY AREAS Mental Health Promotion & Addictions Prevention Tobacco and Vaping Reduction Sexual and Reproductive Health Child and Youth Development Healthy Eating Injury Prevention Environmental Health Physical Activity PROJECTED START DATE PROJECTED END DATE PRIORITY POPULATION: Please check all group that apply Preschool Elementary Junior High Senior High Youth (16-30) Adult Seniors DOES THIS PROJECTC TARGET ANY SPECIFIC GROUP(S)? Indigenous Women Gender-diverse Persons with disabilities or special needs Other ARE THERE OTHER FACTORS IMPACTING PARTICIPANT HEALTH AND WELLNESS? Rural and/or remote community with few programs and services Participants living with chronic disease Lifestyle factors (smoking/vaping/alcohol/drugs, food security, physical activity levels, helmet use, risky driving, recreational vehicle use, etc.) Other HOW MANY PEOPLE ARE EXPECTED TO PARTICIPATE? PROJECT DESCRIPTION HEALTH PROMOTION: How will the project engage participants in health and wellness/learning activities to promote and strengthen healthy living practices? Check all that apply. Displays, reading materials, and/or video (with no facilitator present) Promotional Campaign (print promotions and/or social media) Presentations, workshops, and/or interactive displays (d Active participant engagement with skills development (hands-on learning activities delivered by a facilitator) DURATION OF PROJECT: (The project should be completed within 12 months or by the end of the school year) This is a one time event PROJECT PARTNER(S) Please indicate who is helping with the project and identify their contributions. Check all that apply for each partner (Please refer to WWC Guidelines for suggested partnerships). Partner 1 contributions: Planning and consulting on project activities/resources/evaluation. Providing resources, programs, materials, education and/or facilitation. Providing staff or volunteers to help deliver or carry out the project. Providing space, equipment, or additional funding. Administering project funds (if the group does not have a bank account). Other Partner 2 contributions: Planning and consulting on project activities/resources/evaluation. Providing resources, programs, materials, education and/or facilitation. Providing staff or volunteers to help deliver or carry out the project. Providing space, equipment, or additional funding. Administering project funds (if the group does not have a bank account). Other Partner 3 contributions: Planning and consulting on project activities/resources/evaluation. Providing resources, programs, materials, education and/or facilitation. Providing staff or volunteers to help deliver or carry out the project. Providing space, equipment, or additional funding. Administering project funds (if the group does not have a bank account). Other EVALUATION: How will project success be measured? What methods will be used to determine if project goals are met? You are encouraged to use more than one type of evaluation. Check all that apply. Using the evaluation plan and tools that are included in an existing program (e.g., Color It Up, Strengthening Families, and Walk/Run to Quit Programs, etc.). Participant feedback will be collected (e.g., survey, comment box, focus group, etc.). Organizer/Leader feedback will be collected (e.g., survey, project notes, and summary report based on observations, suggestions for improvement, etc.). Attendance record and/or the number of registered participants. Photos, stories, videos of participants and activities (consents required). Other SUSTAINABILITY: Priority is given to activities that continue to benefit individuals and communities/schools after the project ends. BUDGET EXPENSES - Please list all items/expenses to complete the project. Eligible expenses include materials/supplies, minor equipment, facility costs, honoraria, healthy foods and transporation. COST (how much will it cost) AUTHORIZATION We acknowledge that this application was completed with true and accurate information. If we are successful in receiving funding from the WWC, we will use those funds as outlined in this application. We agree to complete a final report and return copies of receipts within 2 months of completing the project. submit
