Project Proposal Template

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Project Proposal Template
Organization Name
Address
Name of Contact Person
Title of Contact Person
E-mail Address
Daytime Phone Number
Project Name
Location of Project
Project Summary (2 to 4 sentences):
Amount of funds requested (no more than $1,250)
Target audience of project (who, what ages)
# of people potentially reached by project
Source of this number
(e.g., 2010 US Census data for project location zip code)
Project Proposal Template
Organization Name
Address
Name of Contact Person
Title of Contact Person
E-mail Address
Daytime Phone Number
Project Name
Location of Project
Project Summary (2 to 4 sentences):
Amount of funds requested (no more than $1,250)
Target audience of project (who, what ages)
# of people potentially reached by project
Source of this number
(e.g., 2010 US Census data for project location zip code)
Tobacco-Free Policy
To create the healthiest environment possible, Creating Healthy Places strongly suggests there is a
Tobacco-Free Policy passed for the location of the proposed project. For example, funding is requested
for basketball equipment for an outdoor park within a town that has a tobacco-free policy governing all
parks and recreation areas within the municipality.
If there is not a Tobacco-Free Policy currently in place, Creating Healthy Places in partnership with
the St. Lawrence County Tobacco–Free program strongly suggests the municipality/organization
requesting CHP funding commence work toward the adoption of such a policy. Assistance in writing
tobacco-free policy is available.
Is there a Tobacco-Free Policy adopted for
the location of the project
If yes, what year was the policy passed
Passed by what governing agency
(name)
(e.g., Village of
Board)
Please provide a copy of the Tobacco-Free Policy
PROJECT DESCRIPTION -
Grant objectives and activities must directly support the Creating Healthy
Places goal of reducing and preventing chronic illness by creating physical activity opportunities or
improving nutritional opportunities across St. Lawrence County.
Provide a description of your proposed project. Include information on:
how it addresses the goal of Creating Healthy Places;
location of the project;
targeted audience(s);
need for such a project;
other similar resources in the region;
possible partnering agencies and the role of each partner, and;
efforts already underway regarding this project, if any.
RESULTING GHANGES - Proposed grant projects must demonstrate that implementation of this project
will result in environmental, practice and/or policy change(s) at the host facility.
What is an environmental (or facility) change?
A change to the design/built environment to permit the easier performance of an action, course of
conduct, etc.
Example: Rental skates are purchased by a recreation department to promote increased skating
opportunities for the general public at its ice arena.
What is a practice change?
The integration of changes into the daily routine to result in continued practice of this action.
Example: The new rental skates are made available during increased public skating hours and new “Learn
to Skate” classes offered by the recreation department.
What is a policy change?
A major change in attitude, principle, point of view, or practice that is documented in writing and adopted
as the regular course of action.
Example: The rental skates, increased public skate times and new Learn to Skate classes are incorporated
into the recreation department’s schedule of public programming taught each winter and is documented in
writing.
Describe the anticipated environmental, practice or policy changes resulting from the proposed project.
SUSTAINABILITY/MAINTENANCE/SECURITY-
Grant objectives and activities must show
sustainability. Projects should concentrate on environmental, practice and policy change(s) so in the
absence of future Creating Healthy Places funding, the project and resulting changes continue.
Example: A town recreation department establishes a walking/running program that is hosted each summer
as part of its regular activities is an example of a possible funding request. A request for funds to host a one-time
walkathon would not be granted.
Provide a description of:
how your proposed project will be sustained in the absence of future Creating Healthy Places
funding;
what organization will “adopt” the project as its own;
how equipment purchased with grant funding will be maintained and protected from
vandalism.
ADDITIONAL SUPPORTING MATERIALS –
If available, please provide any additional documents
which support your proposal. The more information that is provided, the stronger your application will
be. Documents could include:
Map of proposed project site, e.g. a trail map showing location of fitness stations
Letters of support from community groups showing participation/commitment to proposed
project
Council or Board approval of proposed project
Survey results showing need for proposed project
Newspaper articles about proposed project, need for project, etc.

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