Mental Health Week Activity Grants
May 3-9, 2015
Mental Health and Addiction Services
Guidelines and Application
1. Western Health staff and Community Partners are eligible to apply. Note: Western
Health staff and Community Partners are encouraged to work together in planning
and delivering Mental Health Week activities. You are also encouraged to consult
with Mental Health and Addiction Services or a Wellness Facilitator regarding your
grant application and support/resources for your project.
2. Applications must be received no later than 4:30PM on Thursday, April 2th, 2015.
Please send applications to:
Patti Ryland, Regional Mental Health Promotion Consultant
Western Health
133 Riverside Drive, Noton Building, P.O. Box 2005
Corner Brook, NL, A2H 6J7
F: (709) 634-4888 or E: [email protected]
3. The maximum grant provided will be $150.00. Applications will be reviewed on an
individual basis taking into account the number of participants and activities planned.
Grants will range from $50 to $150 and will be subject to availability of funds. Please
indicate specific amount requested on the application form.
4. Successful applicants will receive a cheque for the awarded amount and an
evaluation/tracking form to be completed upon conclusion of the activity. This form
must be completed and sent back to the address above within 1 month of the
project finish date.
5. Original receipts for purchased items must be sent back with the tracking form to the
address above upon completion of the activity (within 1 month of the project finish
date).
6. In any case that the total amount of the grant awarded was not spent, the remaining
funds should be returned to Patti Ryland with the Cheque payable to the Cashier’s
Office, Western Memorial Regional Hospital.
Contact Information
You are encouraged to consult with Mental Health and Addiction Services or a Wellness
Facilitator regarding your grant application and support/resources for your Mental
Health Week activity.
Regional Consultants
Patti Ryland, Regional Mental Health Promotion Consultant
Tel: (709) 634-4927/634-4171
Email: [email protected]
Tracey Wells-Stratton, Regional Addictions Prevention Consultant
Tel: (709) 634-4921/634-4171
Email: [email protected]
Mental Health & Addiction Services Offices
Corner Brook
634-4506/4171
Stephenville
643-8740
Port aux Basques
695-6250
Burgeo
886-1550
Deer Lake
635-7830
Norris Point
458-2381
Port Saunders
861-9125
Wellness Facilitators
Lisa Henley (Port aux Basques & Area/Burgeo, Ramea & Area/Bay St. George & Area)
Tel: (709) 646-3728
Email: [email protected]
Victoria White (Bay of Islands & Area, Deer Lake, White Bay & Area)
Tel: (709) 637-5000, ext. 6130
Email: [email protected]
Cara Welsh (Bonne Bay & Area/Port Saunders & Area)
Tel: (709) 458-2381, ext. 268
Email : [email protected]
Mental Health Week 2015
Activity Grants
Applicant Information
Applicant Name & Full Mailing Address: Date:
Telephone #:
Fax #:
Email:
*Note: The cheque will be issued in this name.
Partners: Please list any other partners for this project.
You are encouraged to consult with Mental Health and Addiction Services or a Wellness
Facilitator regarding your grant application.
Who did you consult about this Project? Specify: ___________________________
MHW Activity Proposal
Project Name: ______________________________________
Date of Activity: ____________________________________
Location of Activity: _________________________________
Total number of people expected to take part in the Activity: _________
Description of Activity:
1. Please describe your activity.
2. Describe how your activity will promote Mental Health Week.
What types of health promotion resources will you use for the activity? (For
Example: displays, presentations, programs, videos, toolkits, guest speakers, etc.)
How much money are you requesting? (Maximum $150.00) __________
How will the funds be used? Please list items that you require & the expected cost.
Item
Cost
TOTAL= $___________
Evaluation: How are you going to determine if the event has been a success?
For Office Use Only:
Application Received By: ____________________
Date: __________________
Application Reviewed By: ____________________
Date: __________________
Application Approved By: ____________________
Date: __________________
Amount Awarded: $ __________