ProtectMB Community Outreach and Incentive Grant Application

 
Provide a name for your initiative / proposal that will be used for future reference in correspondence and records.
 

 

Primary Contact

 
Who is the best person for us to contact. Please provide one name only.
 
What email address can we use to notify and update you about your application? Please provide only one email in this field.
 
At what phone number can you be reached?
 

 

Organization Details

 
What is the name of your group, business, organization or charity?
 
 
 
 

 

Project Proposal

 
 
Tell us about the community you intend to reach. Provide specifics wherever possible (geography, demographics, etc), and why you believe this community requires additional outreach to increase uptake.
 
 
How do you intend to reach this community? What activities, products or outreach are you proposing? Be specific about the work that you think will be involved.
 
 
Why do you believe this initiative will accomplish the goal? What past experiences, initiatives or other evidence do you have to suggest that this will work to increase uptake?
 
 
What amount of funding is required to deliver this project? Provide the total amount here.
 
Provide a detailed overview of how you reach that total - what are the general line items (staffing, printing, meals, transportation, etc) that are included in the amount above.
 
 

 

Clinic Partnership

 
Check this box if your proposal includes a pop-up or community clinic, or other vaccination method. If your proposal aims to direct unvaccinated Manitobans to an existing clinic (e.g. supersites), leave this unchecked.
 

 

Terms and Conditions

The Manitoba government will review and adjudicate grant applications. After reviewing a proposal, technical officers may suggest that certain changes be made. For example, the officials reviewing the grant may only wish to approve a portion of a proposed project or initiative, or may suggest that an applicant make certain changes to its initial proposal. If the applicant is uncomfortable with a change suggested it will not be required to carry out the project. Expectations for Funding Recipients To receive a grant from the ProtectMB Community Outreach and Incentive Grant Program, successful Applicants (Funding Recipients) must enter into a Grant Agreement with the Manitoba government. The Grant Agreement will include: • A description of the approved project, activity or initative; • The grant amount and how those funds will be used by the Funding Recipient; • Timeline for deliverables; • Requirement to comply with all applicable Public Health Orders and Guidelines; • Reporting and record keeping obligations; • Insurance and indemnification obligations (if determined necessary by Manitoba based on the type of project or activities involved); • Promotional obligations; and • Any other terms and conditions Manitoba determines necessary. Funding Recipients will be required to promote their project or initiative, including: • Allowing Manitoba to post a link to their approved activity, project or event on the ProtectMB.ca web portal; • Acknowledging the ProtectMB campaign wherever the project is promoted (web, print or social media); and • Reporting project, activity and event outcomes and success to Manitoba via stories, photos and other creative content** that Manitoba can use to celebrate the impact of the program on an ongoing basis. (**The applicant is responsible for ensuring that participants provide the necessary approval for their stories, photo and other creative content to be publicly posted by Manitoba.) By submitting this form, I agree to the terms and conditions listed above.