Drug Free Sussex Initiative Mini Grant Application

March 1, 2020 – June 1, 2020 / All funds must be used by July 31, 2020

Name of Group/Organization:
Address of Group/Organization:
Adult contact name and phone (18+)
Contact email address:
Event Location/s:
Target Population?

Requested Amount (Please check one)
$250 (serving 50 and under)
$500 (serving 50-75)
$1000 (serving over 100)

Proposed Activity/Event:

Event must include Prescription Drug Prevention and Opioid, Drug & Alcohol Prevention Awareness including vaping information targeted for ages 12 to 25 years old. Developmental Asset information should be utilized when appropriate and if your organization does not have materials then can be requested from SCHC. For large projects serving over 100 the cost of materials will need to be factored into the proposal.


Type of Event?

Do you need Prevention Materials?
Yes
No
Potential number of people impacted:
Please check the types of Prevention Materials needed.
RX
Opioid
Drug
Alcohol
Vaping
Search Institutes Developmental Asset Materials.

Other:

What type of Prevention message?
Target age of Potential people impacted?
Middle School
High School
Young Adults
Families
Will there be Evidence Based Program?
Yes
No
If so what type?
Would you like help connecting with technical assistance?
Yes
No
Collaborative Partners?
Yes
No

We agree to attend the Developmental Asset Training Class provided by SCHC prior to the events? *
Yes
No

Your First Name
Your Last Name

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