Youth 2023 Mental Health Month Grant Application Form

This form cannot be saved, we recommend preparing your answers in a document and then copying them into this form.

Organisation Name

Your Name

Address

Address 2

City/Town

Postcode

Email address

Phone number

grant amount

$500

$1000

Alternate amount

If your application for a $1000 grant is unsuccessful it will be considered for a $500 grant. Please check this box if you do not want to be considered for the $500 grant

Please provide a brief description of your group/organisation

Max 100 words

Please provide a brief description of the project/event you are proposing, including the aims

Max 200 words

How will the event promote mental health and integrate the theme “We all Have a Role to Play"?

Max 200 words

How will young people be involved in the planning and implementation of this project?

Max 150 words

Please provide a brief outline and timeline of the project/event implementation plan (bullet point is fine)

What are the expected issues/barriers to the success of your project/event and how do you plan to address them? (Bullet point is fine)

How will you know the event/project has been successful?

Consider the number of people who have engaged/been reached, the time spent, follow up contact, or any other measures that reflect the success of your project.

Will you be partnering with any other organisations for this event? Please list

Budget and project details

Please provide details of proposed income for this event/project, including sources, amount, and total proposed income

For example: WayAhead grant - $500 Donations from local business - $200 Total - $700

Please provide details of the proposed expenditure for this event

For example: Printing - $100 Art supplies - $50 etc...

Other:

Declaration

• I confirm that I am authorised to apply for this grant on behalf of the organisation listed. • All the information submitted in this nomination form is true and accurate in all material respects and is not misleading in any material way. • The products and services provided by the applicant comply with all applicable laws and are suitable and fit for the purposes for which they are provided and there are no unresolved significant complaints or claims relating to the applicant's products and services. • By making this application I agree that if I am successful in receiving a small grant but for some reason I am not able to hold my event I will return the grant funds to the WayAhead - Mental Health Association NSW • I agree to return a brief report, including a feedback form distributed to participants during my event/project. Information for these, including guides to feedback forms, will be provided by WayAhead to successful applicants.

I agree

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