COMMUNITY EDUCATION & PREVENTION PARTNERSHIP GRANT
GUIDELINES
Additional information, including applications, is available at www.DMMHRSB.org.
ELIGIBLE APPLICANTS
 Incorporated agency registered with state as a 501(c)(3) non-profit corporation
 Governmental entity
GRANT AMOUNT
Maximum grant amount $10,000
LIMITS
Two consecutive years
RESTRICTIONS
Grant funds may NOT be used for food, lodging, cash payments to recipients of services, capital
improvement, construction, professional or credentialing fees, licenses, fines, penalties or to
supplant existing funds for staff or programs.
PUBLICITY
Grant recipients must agree that all information made available to the public, via media releases
and program materials, will include wording that the activities and/or materials were made
possible through a grant from the DMMHRSB.
CHANGES
Anticipated significant change in the overall plan of the program/project is to be reported in
writing as soon as practical during the award period. The program/project revision must contain:
 Explanation of the proposed change
 Explanation of the impact of the changes to the program/project as originally proposed
 Revised program/project goals and outcomes
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TERMS
The Board reserves the right to:
 Allocate funds to some, none, or all of the applicants
 Negotiate with any or all of the applicants to alter any terms of the responses submitted
by the applicants
In evaluating applications, the Board will consider:
 Completeness and clarity of application
 Alignment with DMMHRSB strategic plan
 Quality of the service
 Cost effectiveness of the program/project
 Use of evidence-based practices
 Innovative approaches
 Past performance and compliance with requirements of contracts or grants
REPORTING
 For programs lasting 12 months, a mid-point program report is required at 6 months from
the date the grant was awarded.
 A final program evaluation report is to be submitted to the Board, on the required form,
within 30 days of completion of the program/project and no later than 12 months from
the date the grant is awarded.
QUESTIONS & TECHNICAL ASSISTANCE
Questions may be directed to Amy Hill (ahill@ohiopps.org) or Melissa Salyer
(msalyer@ohiopps.org) at 740-368-1740
RECEIPT & NOTIFICATION
The application for the grant should be completed electronically and e-mailed to
ahill@ohiopps.org
If unable to submit the application electronically, the application may be mailed or handdelivered to:
Delaware-Morrow Mental Health & Recovery Services Board
40 North Sandusky Street, Suite 301
Delaware, Ohio 43015
Applicants shall be notified in writing as to whether a grant will be awarded or not. Each
approved grant recipient will receive an award contract. Execution of the award contract in a
form satisfactory to the Board is required for receipt of the award.
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INSTRUCTIONS
To complete the information requested for each component of the application:
1. Left click on the adjacent grey box
2. It should turn blue, allowing for information to be typed in the box
GRANT APPLICATION COVER PAGE
Complete all information requested.
PROGRAM/PROJECT OVERVIEW
Provide a brief description of the proposed program/project that is no more than one page.
GOAL(S) OF PROGRAM/PROJECT
Define the overall goal(s) that is hoped to be accomplished by the program/project.
WHY THIS PROGRAM/PROJECT?
Explain why the program/project was chosen. What identified need(s) in the community does
this address? How was the need identified?
TARGET POPULATION(S)
Define the population group(s) that will be targeted by this program/project?
SERVICE TO BE PROVIDED
Describe the activities that will be provided in order to impact the target population. What are
the important and distinct functions of the service? Is this an evidence-based or promising
practice? How will the quality of the service be assured? Identify any innovative aspects.
STAFFING
Describe the roles of the individuals involved in providing the program/project and/or service(s),
as well as their qualifications.
COLLABORATION/PARTNERSHIPS
Identify collaborations and partnerships with other organizations that maximize the quality and
effectiveness of the program/project.
EXPECTED OUTCOMES
Define the specific outcomes that will be accomplished through this program/project, especially
those regarding the impact to the target population(s). What measures will you use to determine
whether the outcomes are achieved or not? How will it be determined that the program/project
was a success?
IMPLEMENTATION PLAN & TIMELINE
Provide the steps involved in providing this program/project and the associated timeline from the
beginning to the end.
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SUSTAINABILITY
If this is an ongoing program/project, explain plans for sustainability after the grant period ends.
ACCOUNTABILITY
Conditions for consideration of a grant award require that:
1. The applicant is not delinquent in the submission of any fiscal reports, governance
and/or informational reports required under prior agreements with the
DMMHRSB.
2. A statement is included affirming that the applicant will perform all fiscal and
program reporting requirements.
BUDGET
Provide a detailed budget for the program/project, including:
 Personnel and related expenses
 Non-personnel expenses
 Administrative costs
 Other expenses
 Estimated revenues
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GRANT APPLICATION
IDENTIFYING INFORMATION
Submission Date:
Program/Service Name:
Name of Organization:
Address:
Contact Person:
Telephone Number:
E-mail Address:
Dollar Amount Requested: $
By signing this grant application, I affirm that the agency will complete all fiscal and
program requirements.
______________________________________
Signature of Organization Executive Director
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_________________
Date
PROGRAM/SERVICE DESCRIPTION
Program/Project Overview:
Goal of Program/Service:
Why This Program/Service:
Target Population(s):
Service to Be Provided:
Staffing:
Collaboration/Partnerships:
Expected Outcomes & Measures (Customer & Community Focused):
Implementation Plan/Timeline:
What are the plans to sustain the Program/Service?
What are the plans to sustain the Program/Service?
BUDGET
Please attach a Program/Service Budget explaining how the funds will be used.
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