Healthy Student Bodies Grant Application | HealthUnit Haldimand-Norfolk

School name:

Address

Street Address City Province Postal Code

Healthy school lead/champion or staff/parent advisor:

Email

Phone

Ext.

Please select your school/committee’s identified priority health topic

Physical activity
Growth and development
Healthy eating
Personal safety and injury prevention
Mental health and well being
Substance use, addictions and related behaviours

Does your school have a Healthy School Committee?

Yes
No

If yes, who is it comprised of?

Has your school had a meeting with a public health nurse or health promotor about the healthy school approach?

Yes
No

Did you use a tool/process to assess and plan for your healthy school initiative?

Yes
No

If yes, what tool or process did you use?

Which of the five components of comprehensive school health does your initiative address? (check all that apply)

Curriculum, Teaching and Learning
School and Classroom Leadership
Student Engagement
Social and Physical Environments
Home, School and Community Partnerships

Is your planned initiative sustainable and/or will lead to lasting change beyond the funding period?

Yes
No

Please describe your initiative and what activities your school team is planning to support your health topic this year.

How will you use the grant funds?

Applications submitted by:

Acknowledgement*

By checking this box I acknowledge that the principal named above has been informed and approves of this grant application.

Note: The Health Unit will gladly provide support or guidance in the planning, implementation or evaluation of the proposed project, as appropriate and feasible. We, the potential grant recipient, agree to:

Have at least three students and at least one adult ally support the project.
Provide an overview of the intended project(s)
Complete and return an activity reporting document by June 14th, 2019.
Provide copies of receipts and/or invoices for any items or services purchased.

Healthy Student Bodies Grant Application – 2018-19