Grant Application Form - Crisis Intervention and Public Information Society (NEED2)
Grant application from NEED2 for $1,000 to support the Youth Suicide Prevention Program (YSPP).
Grant Application Form
Grant Applications must be received by the Town on or before March 1st, 2021
Basic Information
For what type of grant are you applying?
Category: [X] Program (annual operations)
Project / Event / Program Name & Description: Youth Suicide Prevention Program (YSPP) - The YSSP is made up of a combination of school-based workshops and online crisis support (Youthspace.ca). Together, these initiatives empower youth to be able to: recognize signs of anxiety, depression and suicidality; recognize and reach out to local supports; develop and practice positive coping skills; respond to friends in distress; and access low-barrier, online crisis intervention and emotional support to decrease the risk and severity of harmful coping behaviours.
Grant amount applied for? $1000
% of project/event/program budget: 0.2 %
Date the project, activity, event or program will occur: April 1 2021 - March 31 2022
Has your organization ever received grant funding from the Town? [X] Yes
- If yes, attach copies of printed material which acknowledged the financial support of the Town.
Has your organization received a permissive tax exemption from the Town? [X] No
- If yes, in what year(s)? _______________________________________________
Does your organization issue grants to other organizations? [X] No
- If yes, you must demonstrate that any funding provided by the Town will not be used to fund grants to other organizations and attach it to this grant application form.
Attachments Required
- Resolution of Board of Directors to request a Grant in Aid from the Town of View Royal.
- ** If there is no Board of Directors, a statement of request must be signed by the majority of the members of the non-profit or community organization.
- Prior years financial statements of the organization.
- Documentation Town funding will not be used to fund grants to other organizations (if applicable)
About Your Organization
Legal Name of Organization: Crisis Intervention and Public Information Society of Greater Victoria
Mailing Address: 2390 Arbutus Rd, Victoria BC, V8N 1V7
Operating at: Same as above.
Ph: ( ) _________________ Fax: N/A Email: admin@need2.ca
Contact: Maria Weaver Title: Acting Executive Director
Society Registration Number: S1969 Year Registered: 1971
Charity Registration Number: 118879790RR0001 Year Registered: 1971
Year Founded: 1971 Fiscal year end: 31 / March (day / month)
List any other geographic areas in which your organization operates: Our school-based workshops are hosted in schools across Greater Victoria (right now due to COVID-19 this is happening virtually). Youthspace.ca is accessible nationally.
Your Organization’s Personnel
1) Organization Executive and Staff:
- President: Kelly Farish
- Secretary/Treasurer: Miho Kubota/Taryn Castles
- Board Members:
- Robert des Trois Maisons, Director
- Julia-Anne Morris, Director
- Tonja DeRoy, Director
- Nick Beatty, Director
- Maureen Johnson, Director
2) List the staff or volunteer positions involved in carrying out the project:
| Name and Position | Paid | Volunteer |
|---|---|---|
| Please see attached list for details. | ||
Your Organization’s Objectives and Services
1) Describe your organization’s mission statement and how your services meet them: We work every day to prevent deaths by suicide through our community programs and our online presence. We provide accessible emotional and crisis support by engaging the community and advancing the dialogue. The Youth Suicide Prevention Program (YSPP) addresses these aims through a combination of in-school programming and accessible, youth-focused online emotional support. Through the YSPP youth are empowered to be able to: recognize signs of anxiety, depression and suicidality; recognize and reach out to local supports; develop and practice positive coping skills; and respond to friends in distress.
Your Proposed Program Budget
1) Please list all expenses and sources of project revenue, including “in-kind” contributions from your (or any other) organization.
| A. Income | Last Fiscal Year (If program was in existence) | This Fiscal Year (Proposed program budget) |
|---|---|---|
| Town of View Royal | Please see attached supporting documentation. | Please see attached supporting documentation. |
| Fees or Membership Dues | ||
| Government Revenue (specify below) | ||
| Interest income | ||
| Bingo revenues | ||
| Direct access revenues | ||
| Fundraising projects | ||
| Other Revenue (specify below) | ||
| TOTAL INCOME |
| B. Expenses | Last Fiscal Year | This Fiscal Year |
|---|---|---|
| Administration | ||
| Wages/Honouraria/Benefits | ||
| Supplies and Equipment | ||
| Major Capital Costs | ||
| Mortgage/Rent/Utilities | ||
| Fees (licensing, etc.) | ||
| Insurance | ||
| Advertising/Printing/etc. | ||
| Other (specify below) | ||
| TOTAL EXPENSES |
Details of Your Organization’s Grant Request
1) Nature and goals of the project, program or event: The YSPP is comprised of Youthspace.ca (an emotional and crisis support service accessible to all youth <30 via text and instant messaging), Suicide Education and Awareness (classroom presentation that delivers mental health literacy and suicide prevention tools to Grade 8 & 10 classes) and Mindfulness for Middle Schools (workshop series during which Grade 6 & 7 classes learn about mindfulness as a preventative coping tool). Collectively, the goals of NEED2’s YSPP include helping youth, young adults, parents and community members: recognize stressors that contribute to depression /anxiety/suicidal behaviors; explain adaptive and maladaptive behaviors in response to these stressors and explore alternatives and tools to respond to those stressors; identify signs and symptoms of depression and warning signs and risk factors of suicide and know how to respond; and adopt tools to support improved coping and resilience. In addition, the YSSP aims to: provide a safe online space where area youth can go for support and information; challenge the stigma and silence that surround suicide and mental illness; and work creatively with other services and systems that support youth to enhance our collective capacity to meet mental health and emotional support needs.
2) Summary of direct and indirect benefits to the Town of View Royal: Youth living in View Royal will have access to school-based programming aimed at foster healthy coping tools and mental health literacy. Historically, our workshops have been delivered to 400+ students at Shoreline Community Middle School, Rockheights Middle School, Colquitz Middle School, Esquimalt High School and Ecole Victor-Brodeur. We anticipate the level of service will be similar through the current school year. In addition, Youth (<30) in View Royal will have access to Youthspace.ca for crisis and emotional support. We collect limited demographic data from our users; however, Youthspace.ca is given as a resource during our in-school presentations and is used by thousands of youth across Canada. Roughly 10% of our chats come from the Greater Victoria area. Finally, NEED2 recruits and trains over 80 volunteers each year. Most of our volunteers come from the Greater Victoria area, and this opportunity will be open to View Royal residents. Volunteers at NEED2 gain invaluable training and experience with emotional support, crisis intervention and risk assessment skills and working with youth.
Conditions of Funding
- The applicant must acknowledge the support of the Town in all printed and publicity material related to the project, event, or program;
- Funds must be used for the purpose for which they were requested. Any funds not used for the requested purpose must be returned to the Town.
- Funds will be released as follows: a. Grants in aid provided for annual programs will be released at 100% at time of approval by Council; b. Grants in aid provided for special projects or events will be released at 50% at time of approval by Council and 50% after receipt of the final report; c. Conditional grants in aid will be paid 100% upon satisfactory proof that the conditions, as set by Council, have been met.
- Organizations receiving grants from the Town shall provide an accounting of the project or program for which the grant was approved as follows: a. Where the grant in aid was for a specific project or event the applicant must submit a final report within 45 days after the project or event is complete. b. Where the grant in aid was in support of an annual program, the applicant must submit a final report within 60 days of the end of the organization’s fiscal year.
- An final report must include the following information: i. Evaluation of the project, event, or program; ii. Financial statement of actual revenue and expenses for the project, event or program; iii. Attendance figures, if applicable; iv. Number of participants in the project, event, or program; and v. Evaluation of the direct and indirect benefits to the Town.
- In the event that the project or program is not completed, the grant recipient organization must notify the Town as soon as practical and refund any grant funds that have been provided for that project.
Your Directors’ Declaration
We, the undersigned, do hereby certify that this application and all appended forms and/or documents contain a full and accurate account of all matters stated:
Name: Taryn Castles Title: Treasurer Date: Feburary 19, 2021
Name: Kelly Farish Title: Chair Date: February 19, 2021
Please submit your completed application to: Town of View Royal 45 View Royal Ave Victoria, BC V9B 1A6 www.viewroyal.ca Fax 250-727-9551 email: finance@viewroyal.ca
Document Images
(2)
