Farm to School BC Grant Application Form * indicates required field Page 1 of 6 School Information * School Name: * School District #: * Address: * Phone: Website: * Entire Student Population: * All Grade Levels Taught at School: K123456789101112 * Select School Type: ElementaryMiddleSecondaryIndependentFirst Nations Lead Applicant * Name: Position: * What is the best way to reach you? PhoneEmail * Email: * Phone: Next Page 2 of 6 * Select the F2SBC grant you are eligible for: Up to $3,500: Our school has never received a F2SBC grant before or the last time our school received a F2SBC grant was prior to 2014Up to $1,000: Our school has received a F2SBC grant between 2014 and 2016.Uncertain If you are uncertain, please contact the Provincial Manager at firstname.lastname@example.org 1. Please check all the food-related activities and programs happening at your school. School gardenCooking classes/activitiesCompostingSchool Fruit & Vegetable Nutritional ProgramPreservationFarm tourMeal programVermicompostingMicrogreensSeedling SaleSalad BarHydroponicsFruit Tree PlantingBeekeeping Other food-related activities: * 2. Describe what you plan to do if you are awarded this grant. 3. How many from each group do you anticipate will participate and benefit from the program? * a. Total Number of Students: * b. List grades and number of students for each grade level: Are you planning to scale up your program to include more students? YesNo BackNext Page 3 of 6 Core Elements 4. How will your Farm to School activities integrate the core elements of Farm to School? * a. Healthy local food How will your school source food locally? (e.g., farmers, community gardens, school garden, food distributors, grocery stores, etc…) * b. Hands-on Learning How will your activities align with the BC curriculum and enhance food literacy skills? (e.g., lesson plans, courses, field trips, science labs, etc…) * c. School-Community Connectedness How will your activities enhance your school's connection to the broader community? 5. It is important for grant recipients to ensure that their Farm to School program is sustainable. Financial sustainability: * How will your school ensure your program is financially sustainable? Will you charge for your school garden program? How invested in this project is your school district and/or PAC? Will they provide monetary support? Operational/Logistical sustainability: * How will your school ensure your program is operationally and logistically sustainable? Are you going to host garden committee meetings? If so, how often? Who will chair these meetings? Educational sustainability: * Is curriculum connected to your F2S activity? If so, how? If teachers are developing the curriculum, have you talked to your school district learning department about creating additional support and resources? * 6. Farm to School BC programs are most successful when there is a collective team effort (e.g. school administration, school staff, health authority partner, community supporter). Please list the members of your team and their respective duties/roles in the program. Please note that not all positions need to be filled (minimum of 2 supporters). Name: Title: Organization/Affiliation: F2SBC Program Role: Phone: Email: -+ Click the plus button to add another team member. BackNext Page 4 of 6 Environmental Health Officers 7. Environmental Health Officers (EHO) are valuable points of contact for assisting schools in ensuring that their plans meet regulation standards if they involve using food. They may also be able to assess some of the food safety practices of the farms or market gardens supplying your food as well. Although some school proposals do not require EHO approval, we strongly recommend that you involve them in your program. Although some school proposals do not require EHO approval, we strongly recommend that you involve them in your program. (If you are unsure who your local EHO is, please check our EHO contact list here. If you still cannot identify your local EHO, please contact your respective Public Health Dietitian.) Our Farm to School program does not require consultation from the EHOWe are already or will be working together with an EHO EHO Name: EHO Phone: EHO Email: Budget * 8. Please provide a budget for your proposed Farm to School program. Please download the excel budget template file, add your details, and upload it here. Supported File Types: xls, xlsx, doc, docx, pdf, txt, jpg, jpeg, png, rtf, odt | Upload Limit: 4mb Note: Your total expenses amount cannot exceed the requested amount from F2SBC Farm to School BC Signature Form * 9. Although a Farm to School team is diverse, it is especially important that school administrators are informed and have pre-approved your application. Please submit the Farm to School BC Signature Form with signatures attached. Supported file types: pdf, txt, doc, docx, jpg, jpeg, png, rtf, odt Upload limit: 4mb 10. Optional: Please attach any letters of support (e.g., community partner, school district): Supported file types: pdf, txt, doc, docx, jpg, jpeg, png, rtf, odt Upload limit: 4mb BackNext Page 5 of 6 11. Successful recipients of the grants have a few responsibilities: a. Submit a financial report (template to be provided) accompanied by all receipts by June 2019 and June 2020. We require that all schools spend most of their funds by the end of the 2019 - 2020 school year. b. Submit a school year-end report for the 2018/19 and 2019/20 school years (for 2 years) c. Submit pictures that showcase program progress (submitted with the year-end reports). Please let us know who will be the contact person for the deliverables (must have at least two people). Main Contact * Name: * Email: * Phone: Alternative Contact Name: Email: Phone: Cheque Information Please provide the full legal name and address of the school. Please note that the cheque cannot be made out to an individual. Cheque to be made out to: * School Name: * School Address: Attention: Contact Person for Cheque Name Email: Phone: BackNext Page 6 of 6 Evaluation of F2SBC Farm to School BC is planning to evaluate the impact of the program on students and the school community. If you are a successful recipient of a F2SBC grant, we would like to invite your school to participate in our evaluation. We plan to use a mix of qualitative and quantitative methods (online surveys, key informant interviews with students, parents, teachers and school administrators, focus groups). Your participation is voluntary and you can opt out at any time. More information will be provided at a later date. Would you be interested in participating in the evaluation process of our program? (Note: your decision to not participate will not affect your application result) YesNo For more information, please contact Richard Han, Provincial Manager of F2SBC at email@example.com.