Children s Aid Society of Pictou County Endowment Fund. Application and Criteria January 2015

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1 Children s Aid Society of Pictou County Endowment Fund Application and Criteria January 2015 Revised: January 2015

2 GENERAL INFORMATION The purpose of the Children s Aid Society of Pictou County Endowment (hereinafter known as CAS Endowment Fund ) is to generate annual funding opportunities in Pictou County for programs and organizations that: help to alleviate risk and prevent crisis in the home, school and community; enhance the potential for healthy outcomes for children, youth and families at risk in our community; provide education for citizens and program leaders in health, wellness and crisis prevention and intervention; support the delivery of health and wellness. Priority for funding will be based on community projects that address one or more of the above areas of health and wellness; in particular, programs or projects as outlined in the application form of the CAS Endowment, which will make significant contributions to children, youth and families at risk in our community in accordance with the Determinants of Health. (Appendix A) CAS ENDOWMENT FUND ELIGIBILITY GUIDELINES The CAS Endowment Fund Committee seeks applications pertaining to, but not limited to, the following areas: o Proposals that directly or indirectly alleviate risk and prevent crisis in the home, school or community and enhance the potential for healthy outcomes; o Projects and programs that have an element that will support the delivery of healthcare and wellness in Pictou County; Proposals shall demonstrate financial need; Proposals shall demonstrate fulfillment of a need within the boundaries of Pictou County; Proposals for projects where funding comes from multiple sources will be considered; Funding is intended for projects that are short term in nature, generally less than one year; Proposals for funding shall be submitted on a per-project basis. Where appropriate and with proven measured success, projects may be subject for renewal but will be required to re-enter the application process; Enhancements to current projects and programs will be given consideration; Proponents shall provide evidence of a satisfactory financial records system; Only Qualified Donees, as that term is defined, holding a Canada Revenue Agency charitable number shall be considered. THE FOLLOWING WILL NOT BE CONSIDERED: Retroactive applications; Funding for current programming costs at current capacity levels; Projects or activities which can be funded under existing government programs; Projects or activities which DO NOT: o OR o directly or indirectly alleviate risk and prevent crisis in the home, school and community and enhance the potential for healthy outcomes. contain a health component and/or which are not reasonably incidental and ancillary to the delivery of health care and wellness in Pictou County; Revised: January 2015 Aberdeen Health Foundation 2

3 APPLICATION PROCESS Applications will be welcomed by the CAS Endowment Fund Committee of the Aberdeen Health Foundation through the following processes: Applications are available at the Aberdeen Health Foundation office, Aberdeen Hospital, 835 East River Road, New Glasgow or Completed applications are to be hand delivered or mailed to the Foundation Office; The CAS Endowment Committee will review all applications and adjudicate according to the eligibility guidelines before making its recommendations to the Aberdeen Health Foundation Board for approval; The Aberdeen Health Foundation office will notify the applicants in writing on the outcome of their application. TIMELINES Applications will be received once annually by the CAS Endowment Committee of the Aberdeen Health Foundation. Applications for 2015 funding must be received at the Aberdeen Health Foundation office at the Aberdeen Hospital on East River Road on or before March 31, RESPONSIBILITIES OF APPLICANTS To complete the application form and application questions in full, and attach the following documents: o Recommendation letters from appropriate sponsors and/or partners in the community; o The most recent Financial Statements for the organization; o A detailed Budget for the project. To ensure the group/organization receiving the funding adheres to all Provincial and Federal regulations; To ensure the organization has on file current Child Abuse Registry Forms and Criminal Record checks for all individuals on the project that will be in direct contact with children and youth; To ensure the funding is spent as laid out in the application plan; To ensure reports, receipts and a budget summary are submitted to the CAS Endowment Committee on a regular basis, as directed in the letter to successful candidates; Applicants agree to give permission to the Aberdeen Health Foundation (AHF) to use information and any images related to projects funded by the CAS Endowment Fund for AHF electronic use, print publications and/or use by news media subject to permission being granted by individuals in pictures. For information about the Children s Aid Society of Pictou County Endowment Fund contact: Susan Malcolm Executive Director Aberdeen Health Foundation Phone: (902) ext 4600 Fax: (902) susan.malcolm@pcha.nshealth.ca Revised: January 2015 Aberdeen Health Foundation 3

4 APPLICATION FORM CAS Endowment Fund All correspondence must be legible, organized and include all supporting information and documentation. Project Name: Group/Organization Name: Contact Person: Title: Mailing Address including Postal Code: Telephone Numbers - Work: Cell: (please indicate preferred number for us to contact) Address: Website Address Signing Officers for the organization: Canada Revenue Agency charitable number: Signature of Applicants: (Chair or designate and one other member of the group or organization.) Signature of Chair or Designate Please Print or Type Name: Dated: Signature of Group Member Please Print or Type Name: Dated: I have verified that the organization has a current copy of the Child Abuse Registry Forms and Criminal Record checks for all individuals on the project that will be in direct contact with children and youth. Initials of Applicants Revised: January 2015 Aberdeen Health Foundation 4

5 PROJECT SPECIFIC INFORMATION Please provide the information requested below, with as much detail as possible to help the CAS Endowment Committee evaluate and consider your project. To ensure the application can be reviewed by the Committee, complete the questions in full, and attach the following documents: Recommendation letters from appropriate sponsors and/or partners in the community; Most recent Financial Statements for the organization; A Detailed Budget - note that salaries of new or existing staff may not be included (Appendix B, Budget Form may be used as a guideline) 1. What is the project and what are the objectives of the project? Explain how this will help children and families at risk. Describe your project with as much detail as possible, including which Determinants of Health will be addressed. (see Appendix A) 2. What community partners, organizations, agencies will participate in the development and implementation of the project? 3. Who is the target group for your project? (i.e.who will benefit from the running of this project?) 4. Where will your project take place? (at agency location or other areas) 5. What is the aim of your project? What do you want to accomplish? (These are your goals and objectives and how the project will be of benefit to your community.) 6. How long is this project to last? 7. Will you receive funding from any government department for this project? 8. Will you apply for funding from other sources for this project? If yes, please explain all sources of funding for your project. 9. How do you plan to evaluate the project? (i.e. What tools will you use to measure your success? Your evaluation should specifically measure the achievement of each of the goals, objectives, and desired impacts you have outlined above.) 10. How will the project activities continue beyond the CAS Endowment Funding? Does this project have potential to become self-sustaining? Will it continue after the completion of the funding? 11. Due to funding availability the CAS Endowment Fund may not be able to provide full funding as requested. Do you have an alternative plan should you not receive full funding? Please provide details. 12. How has your organization demonstrated the ability to successfully deliver projects in the past? Revised: January 2015 Aberdeen Health Foundation 5

6 APPENDIX A DETERMINANTS OF HEALTH Health is not merely determined by the absence or presence of disease. It is dependent on many factors. These are known as the determinants of health. Culture Customs, traditions and beliefs of families and communities all affect health. Culture influences thoughts, feelings, actions, and beliefs. Education Research shows that low literacy skills are linked with poor health. The more education we have, the more likely we are to be healthy. Employment and Working Conditions Unemployment is linked with poor health. People who have jobs are healthier when they have more control over their working conditions. Gender Gender has an impact on income levels and types of jobs and can influence conditions and diseases at different ages. The differences in the way society treats men and women can also have an impact on health. Genetics Physical characteristics we inherit play a part in how long we live, how healthy we ll be, and how likely we are to get certain illnesses. Health Services It benefits people s health when they have access to services that prevent disease as well as maintain and promote health. Healthy Child Development How children grow and develop in early years affects health. Prenatal and early childhood experiences influence health, well being and competence. Income and Social Status Research shows that poor people are less healthy than rich people. The greater the gap between the richest and poorest people, the greater the differences in their health. Personal Health Practices and Coping Skills Personal practices - healthy eating, physical activity, smoking all have an impact on health. A person s coping skills how they relate to people, stresses and challenges also affect health. Physical Environments Clean air and water, healthy workplaces, safe houses, roads and communities all have an impact on health. Social Support Networks Support from family, friends and communities is linked to better health. This support helps people handle difficult situations. Revised: January 2015 Aberdeen Health Foundation 6

7 APPENDIX B BUDGET FORM This form is a guide only. Your project may not include all expense categories listed and may include categories not shown below. EXPENDITURE BUDGETED AMOUNT Remuneration (facilitators, contractors) Training Costs Travel (i.e. bus tickets, personal vehicle per km please specify rate, train, etc) Office supplies/project Materials Advertising/Marketing Office Expenses Equipment Rentals/Leases Space Rental Other Costs (i.e. food, snacks, child care, etc. Please specify your other costs). Total Cost of Project Less funding from other sources TOTAL REQUESTED IMPORTANT NOTE: The CAS Endowment Fund will not cover salaries of new or existing staff. Please do not include in your budget. Revised: January 2015 Aberdeen Health Foundation 7