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2020/2021 CIVIL FORFEITURE CRIME PREVENTION
AND REMEDIATION GRANT PROGRAM
APPLICATION FORM
STREAM: CHILD AND YOUTH ADVOCACY CENTRES
*Please review the Application Guide before completing this form. The Application Guide can be found here:
http://www2.gov.bc.ca/gov/content/safety/crime-prevention/community-crime-prevention/grants
SECTION 1 APPLICANT INFORMATION
Project Title:
Legal Name of Organization:
Name of CYAC/CAC:
Location of Project (specify city/cities):
Organization’s GST/Business Number:
Applicant’s Mailing Address (Street and
Number):
Suite Number:
City/Town:
Province:
Postal Code:
Physical Location (if different from
mailing address):
Contact Person 1:
Telephone:
Email:
Contact Person 2:
Telephone:
Email:
Existing CYACs include:
Sophie’s Place CYAC (Surrey)
Alisa’s Wish CYAC (Maple Ridge)
Treehouse CYAC (Vancouver)
SKY Coordinated Response (Kootenay
Boundary)
First Nations CYAC (Prince George)
Oak Centre CYAC (North Okanagan, Vernon)
Victoria CYAC (Victoria)
Kelowna CAC (Kelowna)
Big Bear CYAC (Kamloops)
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Focus on Child and Youth Advocacy Centres
This
stream provides up to $70,000 in one-time funding for proposals that will enhance the capacity,
development, or improvement of service(s) within an existing Child and Youth Advocacy Centre (CYAC)
in communities across British Columbia*.
CYACs provide a coordinated approach to addressing the needs of child and youth victims and/or
witnesses in the criminal justice system. CYACs seek to minimize system-induced trauma by providing a
single, child-friendly setting for young victims or witnesses and their non-offending family members
and/or caregivers to seek services.
*Note: The termexisting CYAC” refers to an agency that has successfully completed a needs
assessment/feasibility study through Federal Department of Justice funding and has gathered
commitment of relevant stakeholders (including victim services) for the formal establishment of a
multidisciplinary team (MDT) approach. A CYAC that isin development/pilot” oroperational” is
considered “existing”.
Is your organization Indigenous? (E.g. First Nations Band, Tribal Council, Friendship Centre,
Incorporated Non-Profit, Indigenous Community-Based Non-Profit, etc.)
YES NO
Has the project previously received a Civil Forfeiture Grant? If yes, please list which years the project
was funded.
YES Years?
NO
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PROJECT EXECUTIVE SUMMARY:
Provide an executive summary of the project which should include the project’s name, objective,
target group (including approximate number of participants and specific segments of the population
targeted e.g. at-risk youth, homeless, LGBTQ2S+, youth ages 13-19, etc.), and types of activities to
be implemented. Provide a maximum of 5 sentences.
Example: The Two Peas in a Pod mentorship program targets at-risk youth who may be vulnerable to
become involved in gang activities. This program matches at-risk youth with a peer mentor to spend 2-3
hours per week to engage in pro-social activities such as sports, tutoring, and volunteering. It is expected
that 30 youth in this program will become more engaged with their schoolwork and family. The number
of youths charged for a criminal offence is expected to decrease.
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SECTION 2: PROJECT OVERVIEW
The project overview section of the application form should highlight the key aspects of your project
including:
Issue being addressedWhat is the key social issue that your project is trying to address? Why
is it important to address this issue?
P
roject Goals/Objectives What are the objectives/goals of the project in addressing this issue?
When the project is completed, what are you hoping to achieve? How will you measure
s
uccess/how will you know if you’ve met your objectives/goals?
T
arget Participants How will the project identify and engage its target participants? What is
the demographic makeup of your target participants? (e.g. gender, ethnicity, age group). How
many participants will be targeted? How many cohorts will be conducted? How long will target
participants be engaged in the project?
L
evel of Need Why is there a need for your project within the target audience and/or target
community? Highlight any evidence (e.g. research, data, anecdotes) demonstrating this need (if
applicable).
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SECTION 2: PROJECT OVERVIEW CONTINUED
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SECTION 3: KEY ACTIVITIES
What key activities will the project implement to meets its goals? Include project start and end date.
Example:
Use bullet points to list the distinct individual activities with timelines that will be implemented
during the project
List as a step by step blueprint for implementing the project
o E.g. June 1 11, interview and hire mentors for youth participants
o June 10 July 10, screen potential participants based on select project criteria
Project Start Date:
Project End Date:
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SECTION 4 – COLLABORATION
Does your project have any community partners? YES NO
Project Partner
Role
Letter
Included? (Y/N)
Pr
oposals should provide evidence of direct collaboration between partners (i.e., letter(s) from
partners highlighting any collaboration directly related to implementing the project).
Provide no more than 3 collaboration letters from partners directly involved in the project. The letters
must highlight the role of the partner and demonstrate their commitment to fill that role. Do not
provide general letters of support from members of the community that do not have a direct role to
play in implementing the project.
No
te: Collaboration letters should be current and addressed to “The Civil Forfeiture Grants Review
Team”. Letters of collaboration must be received before the deadline to be considered part of your
application. Please ensure letters are dated by the partner.
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SECTION 5 – ORGANIZATIONAL CAPACITY
Proposals must describe how your organization is positioned to address the issue-at-hand and
demonstrate it has the capacity to reach and support the target audience. Describe the experience your
organization and staff have that is directly related to the issue being addressed, the target audience
being reached, and the successful implementation of your proposed project.
Topics should include: Organizational structures in place to support the project; past projects similar to
the one proposed; past experience working with the target population; project planning done in
preparation (stakeholder consultation, strategic planning, needs assessments, etc.), staff
training/qualifications to deliver the project’s activities and support the specific needs of the target
audience.
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SECTION 6 – PROJECT BUDGET
Proposals must contain a reasonable and detailed budget. Consideration will be given to the scope and reach of the project in comparison to the amount of the budget (i.e., value for money). Please round all amounts to the nearest dollar.
All budget items listed must correspond to your project activities as described above. For a list of eligible and ineligible expenses, please refer to the Program Guidelines.
Example: Staff: 1 Programmer x $22.50 per hour x 15 hrs/week x 40 weeks = $13,500
Description
Amount Requested
Amount from Other Sources
Total Project Expenses
TOTAL
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SECTION 7 – DECLARATION
To be signed by an authorized signatory of the sponsoring organization, by signing you agree:
The information contained in this application is accurate and complete;
T
he application is made on behalf of the sponsoring organization named with its full knowledge
and consent;
T
he sponsoring organization is a registered legal entity in good standing;
T
he sponsoring organization has an appropriate accounting method to manage any potent
ial
gr
ant funds;
S
hould a project be approved, the sponsoring organization is required to submit a midterm and
final report. The reports should detail progress against the activities and outcomes described in
the application and how the grant funds are being/were spent. A link to both report templates
will be provided to you if your proposal is successful.
Name of Authorized Representative:
Title:
Signature:
Date:
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