2018 Mental Health Week Small Grants Application 2018 Mental Health Week Small Grants Application Form Please complete the online application form below to apply for a 2018 Mental Health Week Small Grant. Before you apply for a Grant, please review and confirm your group or organisation is eligible and meets the selection criteria. Alternatively, please download and print off the PDF version or Word version of the MHW Small Grants application form. Please complete, scan and return to email@example.com at MHCT prior to the deadline of 16 July. All Grant applicants must register their 2018 event on the MHCT Mental Health Week event website, visit https://www.mhct.org/mentalhealthweek/mhwregistration/ The 2018 Mental Health Week Small Grants program: opens 9:00am on Monday, 18 June 2018 closes 5:00pm AEST on Monday, 16 July 2018 Eligibility Organisations must have an ABN or be auspiced by an organisation with an ABN, and be undertaking the event or activity in Tasmania. The planning activity must clearly align with the theme for Mental Health Week 2018 ‘Stronger Together’.Selection Criteria Small Grants applications will be reviewed and assessed by the MHW Selection Panel. The funding process is competitive and your application will be rated against the following selection criteria. Please also note, your requested funding amount may not be available, and another amount may be allocated, should your Small Grant be successful. Meets all necessary requirements, including incorporating the 2018 MHW theme, ‘Stronger Together’ (compliance) Willingness to explore collaboration and partnership with other organisations/agencies on the event, in particular those targeting the same audience and in the same location (collaboration) Innovation and creativity of the event concept (innovation) Demonstrated clear targets around population size and audience (impact) Demonstrated clear promotional planning and methods (promotion) General InformationOrganisation/ Group:*Organisation website: Event target Audience*(for example, LGBTI, CALD, youth, rural / remote community) Key contact name:* First Last Contact Email:* Contact Phone Number*Address* Street Address Address Line 2 Suburb Post Code Your MHW EventEvent Description*Please provide a brief description of your proposed Mental Health Week event or activity (including your event name) 200 word limitEvent Goals*Describe your event objectives/goals and how you plan to achieve them 200 word limitGrant Amount*Please advise the MHW Small Grant amount are you applying for $500$750$1000$1500$2000Event Date**please note, events must be held within the Mental Health Week period 7-13 October, or directly before or after the period1st October2nd October3rd October4th October5th October6th October7th October8th October9th October10th October11th October12th October13th October14th October15th October16th October17th October18th October19th October20th October21st October22nd October23rd October24th October25th October26th October27th October28th October29th October30th October31st OctoberEvent Time* : HH MM AM PM Event Location*How many people do you expect to attend your event?*PartnershipsPlease describe any partnerships/collaboration with other organisations or agencies on this event (please provide organisation’s name) 200 Word LimitHow do you plan to promote your MHW event to ensure its success?*How to you plan to promote your MHW event to ensure its success, including targeting community members not already engaged with or linked to mental health services/sector? 100 Word LimitEvent Theme*Describe how your event will incorporate the 2018 Mental Health Week theme, ‘Stronger Together’ 200 Word LimitOther InformationGrant Evaluation and AcquittalAre you happy to complete the official MHW Small Grant Evaluation and Acquittal form after your event? Yes Public Liability Insurance*Will your MHW event / activity be covered by Public Liability Insurance?YesNoPlease complete the budget template to show the selection panel how your organisation plans to utilise the Grant funds. For example: $200 may be used to cover the costs of advertising the event $100 may be used to pay staff assisting your event $50 may be used to purchase food/drinks for volunteers $400 may be used for venue hire Event Budget*CostFunding SourceItemPurpose Add as many budget lines as you need by pressing the plus icon at the end of the row. Application Compliance and Checklist Please read, and tick all boxes to show you understand and agree to these terms. I have completed all parts of the application form* Yes I have included a budget* Yes I have indicated the Small Grant amount I am applying for* Yes I acknowledge that if I am successful in receiving a Mental Health Week grant I am prepared to stage my event during Mental Health Week (7-13 October 2018) unless otherwise agreed upon with the Mental Health Council of Tasmania* I Agree I acknowledge that if I am successful in obtaining a grant it has been awarded on the merit of this application therefore if there are any changes to my event following submission of this application OR receipt of a MHW grant I will inform the Mental Health Council of Tasmania of these changes as a matter of priority* I Agree I acknowledge that where there are significant changes to my event application the selection panel have the right to review allocation of grant funding based on those changes* I Agree I acknowledge that the selection panel have the right to consider equitable distribution of funds across the state in their assessment of grant applications* I Agree I acknowledge that the selection panel may offer partial funding and/or attach conditions to the allocation of grant funding* I Agree I acknowledge that if my application is successful I will nominate ONE key contact from the event to liaise with the Mental Health Council in relation to event matters* I Agree I acknowledge that if successful I will be required to provide evidence of appropriate acquittal of funding* I Agree I acknowledge that if successful I will be required to evaluate my event and provide a summary of the evaluation to MHCT within two months of 2018 Mental Health Week* I Agree I acknowledge that if successful in receiving a grant I MUST display the Mental Health Council of Tasmania logo and the State Government logo on promotional material and adhere to the Mental Health Week theme guidelines in the promotion of my event*(please see www.mhct.org/mentalhealthweek for theme guidelines in the media and event kits) I Agree Submitting For A Grant By providing your signature, your organisation is agreeing to the below statements. *Applications that do not sign their application by a representative of their organisation will be deemed ineligible. Applications which are not successful will be notified via email and can be contacted for further upon request. All applications will be assessed by a selection panel comprising of MHCT Media and Communications Lead, A representative from The Mental Health Drug and Alcohol Directorate, a consumer representative and a carer representative. Successful Grant recipient organisations will be notified and asked to provide MHCT with an invoice for the Grant amount, plus GST and including your organisation’s banking details. Once this is received the payment will be processed by MHCT by electronic funds transfer. We aim to have funds deposited to successful applicants by early August. I agree to the above conditions of the application process and can assert that all information provided in this application is true and accurate at the time of submittingPrint Name*Organisation/Group*Date *Please be advised that MHCT will include all grant applicants on the MHCT mailing list to receive updates and information on the mental health sector. The Mental Health Council of Tasmania is proudly supported by the Department of Health, who have provided the available 2018 Mental Health Week Small Grant funding.