2011 Youth Empowerment Mini-Grant Application Made available by: Tobacco Free Kansas Coalition The Tobacco Free Kansas Coalition (TFKC) is a statewide alliance of health, education, parent, youth, law enforcement and other civic organizations and individuals. TFKC advocates for laws, policies and funding of effective programs that will result in significant reductions in tobacco use and addiction, especially among children and highrisk groups. For more information on TFKC please visit www.tobaccofreekansas.org. The Kansas Health Foundation is a philanthropy dedicated to improving the health of all Kansans. Based in Wichita, the Foundation s assets total over $528 million with more than $24 million paid out annually in the areas of children s health, leadership, public health and policy. For more information about the Kansas Health Foundation, visit www.kansashealth.org. Funded by: Kansas Health Foundation 1
About TFKC Since 1996, the Tobacco Free Kansas Coalition (TFKC) has helped empower youth to fight back against the lures of tobacco use. Major strategies have been youth trainings, mini-grants and statewide youth tobacco prevention projects. This is our newest series of youth grants for tobacco prevention. For more information on TFKC please visit www.tobaccofreekansas.org. On Your Mark! ($500) Grant Categories Get Set & GO! ($750) Stand Strong! ($1,000) Eligibility rules YOUTH LED! (With the young at heart assisting) On Your Mark! Establish a YOUTH EMPOWERED Tobacco Prevention Group Get Set & GO! YOUTH EMPOWERED group established and focused on building awareness and counter marketing against the tobacco industry through a significant community-wide program, policy initiative or continuing initiative Stand Strong! YOUTH EMPOWERED group established, focused on implementing a tobacco prevention initiative that can impact entire youth community Evaluation of Applications A panel of current Youth Empowered state board members, Tobacco Free Kansas Coalition staff members, and Kansas Department of Health and Environment staff will evaluate the eligibility and strength of the youth group to ensure they are capable of fulfilling the grant requirements. Technical assistance is available to applicants and grantees. Contact Erica Anderson, Program Coordinator, at eanderson@tobaccofreekansas.org. 2
Application format and deadline Using the enclosed forms, applications are due no later than 5:00 pm, close of business, on September 15 th 2011. Completed applications can be mailed, emailed or faxed to Erica Anderson, Program Coordinator, for Tobacco Free Kansas Coalition, 5375 SW 7th Street, Ste. 100, Topeka, KS 66606, eanderson@tobaccofreekansas.org, Fax 785-272-5870. Requirements of Grantees: Grantees are required to use all funds by the grant cycle end date. Each grantee will provide at least one (1) youth to become a member of the YOUTH EMPOWERED State Board, serving a one year term. Youth group members need to be available for periodic regional travel and conference calls (TBA - See addendum A). Sponsors are responsible for awarded funds and communication with TFKC Regional Consultants, who will monitor grants. Application Proposal Due Sep. 15, 11 Date Grant Announced/Awarded Sep. 22, 11 Regional trainings TBA End of Project Date Dec 22, 11 Project Reports Due Date including copies of media Jan 20, 12 products COMPLETED PROPOSALS MUST INCLUDE: Application Form, complete with three signatures (if you choose to email the application, a signed copy of the application with signatures must be mailed to TFKC. Application Narrative and Activities Outline Grant Category/Budget Page Submit a copy of your group or school s smoke-free or tobacco free school grounds policy with this application 3
Youth Empowerment Application Form Your group s name: County: Name of main youth contact: Address: City: Zip: Cell: E-mail: Signature of youth contact: Name of adult sponsor: Title: Organization: Address: City: Zip: Phone: E-mail: Alternative Adult Sponsor Name: Phone: E-mail: Signature of adult sponsor: Grant awards check should be payable to: (Agency or Group) Name of financial officer: Title: Organization: Address: City: Zip: Phone: E-mail: Signature of financial officer: Who should receive grant correspondence: Adult sponsor Youth sponsor Fiscal How did you hear about this RFP? Does your school have a tobacco free school grounds policy for students, staff, visitors? Please submit a copy of your school s tobacco policy with this application. Yes No 4
Grant Category On Your Mark! ($500) Get Set & GO!($750) Stand Strong! ($1,000) Youth contact that will be serving on the YOUTH EMPOWERED state board Name: Email: Address: Phone: Number of youth involved in grant project: Number of youth to be impacted by your project: Names and emails of youth involved, must at least 5 or more between the ages of 12-18: 1. 2. 3. 4. 5. Budget Explain how these funds will be used in your project. (see Addendum B) Category Total Approved Educational/Promotional Items not to exceed 20% of budget T-Shirts, bags, hats to identify youth members Media Travel YOUTH EMPOWERED training for AT LEAST two members(required) Minimum travel requirement-$100 Food not to exceed 10% of the budget 100.00 Stipends nominal fees for adult sponsor not to exceed 10% of budget. Other cooperative efforts or speaker fee Total Budget 5
Application Narrative and Activity Outline What will you do? Overview What do you hope to accomplish? Goal Specific project timeline dates, if possible Timeline How will you show the impact of your project? Evaluation 6
Activity and Project Recommendations On Your Mark! Get Set & GO! Stand Strong! Impact Survey Of The Smoke Free Law In Your Area Art Contest With Tobacco Focus Develop And Maintain A Youth Prevention Zine Or Newsletter o Online Or Printed Social Media Project o Using Social Media To Educate Peers About Tobacco Graffiti Wall Art Contest Educate Your Community On The Benefits Of A Tobacco Tax Educational Presentation To Policy Makers o Caravan To The Capitol o Caravan To Your State Representatives Office or Local Policy Makers Reality Check Demonstration Create Youtube Spots To Air On Your Local Channels Counter Marketing Tool Survey Healthy Choices Project With Tobacco Prevention Aspect o Marathon, Half- Marathon, 5k, Bike-A- Thon, Walk-A-Thon o Promote Tobacco Free Activity In Your Community Tobacco Free Festival, Fair Or Youth Event Battle Of The Bands With Tobacco Focus Dance Contest With Tobacco Focus Social Media Project o Using Social Media To Educate Peers About Tobacco Educate Your Community On The Benefits Of A Tobacco Tax Educational Presentation To Policy Makers o Caravan To The Capitol Or State Representatives Office Tobacco Free School Grounds Policy Initiative Tobacco Free Outdoors Project: o Playgrounds, Fairgrounds, Recreational Areas, Sporting Events, Etc Impact Survey Of The Smoke Free Law Battle Of The Bands With Tobacco Focus Dance Contest With Tobacco Focus Film Project o Documentary And Showcase Educate Your Community On The Benefits Of A Tobacco Tax Educational Presentation To Policy Makers o Caravan To The Capitol Or State Representatives Office This is only a guide! Put on your thinking caps and figure out what Tobacco prevention means to you and your peers!
Addendum A: State Board commitment We re excited that you re interested in joining the YOUTH State Board! Here are just a couple of things/logistics to consider before jumping on board: YOUTH BOARD state board members will: 1. Be responsible in helping plan for and implement at least one youth event in their part of the state. 2. Attend virtual meetings (conference call, video, etc.) 3. Assist in reviewing upcoming mini grant applications 4. Attend events that are sponsored by the YOUTH BOARD state board 5. Aid in developing media (providing input on print media, website designs, updating facebook and Twitter, blogging, etc) 6. Work to inspire youth from across the state to make healthy choices 8
Addendum B: Budget Please provide specific details of funding usage. This will assist reviewers with funding as well as a quicker delivery of funds once your grant is approved! Category: On Your Mark! ($500) Get Set & GO!($750) Stand Strong! ($1,000) Educational/Promotional Items not to exceed 20% of budget Total Approved T-Shirts, bags, hats to identify youth members Media Travel YOUTH EMPOWERED training for AT LEAST two members(required) Minimum travel requirement-$100 $100 Food not to exceed 10% of the budget Stipends nominal fees for adult sponsor not to exceed 10% of budget. Other cooperative efforts or speaker fee Total Budget 9