Cancer Program Community-Based Programming PROPOSAL TEMPLATE INSTRUCTIONS This template is the re!uired proposal format, to be completed in full.

Please ensure that you follow the instructions below: Type your responses within the boxes of this template when developing your proposal using the same headings and number system. The maximum length for proposals, including the Workplan Template, Evaluation Plan Template, and udget Templates, is !" pages, single#spaced in total. The approximate page length is indicated for each section. Please use Times $ew %oman &ont, 'i(e )!. The Proposal *ssessment +riteria should be considered in your responses ,-uidelines for *pplicants: *ppendix .. PRO"ECT TITLE NAME O# SPONSORIN$ OR$ANI%ATION PRIMAR& CONTACT PERSON' TITLE AN( TELEP)ONE NUMBER

Section *+ Pro,ect Re-e.ance and Need - /p to ! pages a/ (escri0e 1o2 your 3ro,ect addresses t1e so-icitation 3riority+

0/ (emonstrate t1e need 4or your 3ro,ect+ (escri0e 21y it is im3ortant to carry out t1is 2or5+

c/ Pro.ide t1e e.idence to su33ort t1e need 4or t1is 3ro,ect 6e+g+ researc1 e.idence7statistics on your target 3o3u-ation and t1e issue 0eing addressed/+

d/ (escri0e 1o2 your 3ro,ect com3-ements or adds to ot1er simi-ar initiati.es+

Section 8+ Pro,ect (escri3tion /p to !.1 pages a/ Pro.ide a 0rie4 descri3tion o4 t1e 3ro3osed 3ro,ect+

0/ Pro.ide t1e o0,ecti.es o4 t1e 3ro,ect+

c/ 91at 5ey acti.ities 2i-- you underta5e in t1is 3ro,ect:

d/ (escri0e t1e target audience6s/ 4or t1e 3ro,ect 6e+g+ 1ea-t1 3ractitioners' 3o-icyma5ers' underser.ed 3o3u-ation/+

e/ Pro.ide -ist t1e geogra31ic -ocation6s/ 6e+g+ Toronto/ and sites7settings 6e+g+ 1os3ita-' community-0ased centre/ 21ere t1e 3ro,ect acti.ities 2i-- ta5e 3-ace+

Section ;+ E<3ected Resu-ts # /p to ) page # Expected results can be viewed as what your pro3ect is trying to 4change5 ,e.g. change in awareness levels, change in health behaviours. a/ 91at are t1e e<3ected s1ort term 6*-8 years/ and -ong term 6;= years/ resu-ts o4 t1is 3ro,ect:

0/ )o2 do you see t1e resu-ts o4 t1is 3ro,ect a44ecting t1e 1ea-t1 o4 indi.iduaCanadians:

Section >+ Nationa- Sco3e and A33-ica0i-ity - /p to) page # %esults of pro3ects must have national implications and benefits. This can include being national in scope in terms of partners, benefits to the target population, and replicating results in other parts of the country. a/ (escri0e 1o2 t1e resu-ts o4 your 3ro,ect 2i-- 1a.e nationa- im3-ications and 0ene4its+

Section ?+ Mu-ti-sectora- Partners1i3s and Co--a0orations /p to ).1 pages 7escribe your plan for collaboration between practitioners, researchers, policy makers and community organi(ations. Preference will be given to proposals that demonstrate multi#sectoral engagement or involvement. *pplicants are strongly encouraged to partner with organi(ations working in sectors other than cancer. Effective cancer prevention initiatives are enhanced through multi#sectoral responses, involving players such as non#governmental organi(ations, governments ,municipal, provincial8territorial and federal., workplaces, industry, health services, social services, and educational institutions.

a/ Indicate t1e name o4 t1e 3artners you 2i-- 2or5 2it1 during t1e 3ro,ect+

0/ 91at is t1e ro-e and contri0ution o4 eac1 3artner:

c/ P-ease -ist 1ere and 3ro.ide 6attac1/ t1e -etters o4 su33ort demonstrating 3artners1i3 commitment to t1e 3ro,ect+

Section @+ Ano2-edge Trans4er Acti.ities /p to ) page ;nowledge transfer activities move the products, results, and learnings ,best practices and lessons learned. from a pro3ect beyond the pro3ect team to a range of audiences ,e.g. not# for#profit organi(ations, communities, universities8colleges. who can benefit from this material and8or knowledge. Pro3ects must demonstrate the use and transfer of information and knowledge that expands beyond local or regional areas. * knowledge transfer activity is more than disseminating a product or final report. <t can include sharing of lessons learned in workshops and newsletters, developing and sharing fact sheets at events, or posting of tools and information on a web site and sending out notices to existing as well as new audiences. <nclude a description of how you plan to follow#up with your target population,s. to identify how the pro3ect results and deliverables are being used.

a/ 91at 5no2-edge 3roducts or trans4er acti.ities 2i-- 0e de.e-o3ed or conducted as 3art o4 t1is 3ro,ect:

0/ )o2 2i-- your 3ro,ect resu-ts reac1 your target 3o3u-ation6s/ and 1o2 do you 3-an to 4o--o2-u3:

Section B+ Sustaina0i-ity P-an /p to )8! page Time#limited pro3ect funding cannot be used to sustain the operations of organi(ations or to carry out ongoing core operational activities that must cease when funding ends. * sustainability plan could include: sustaining the issue ,e.g. keeping awareness of the issue high on the agenda of all stakeholders including the public, community partners and decision makers.> sustaining programs ,e.g. using volunteers or integrating one or more related activities such as an awareness campaign, a support group, or educational sessions, into one or more existing organi(ations who agree to take responsibility for the program once funding ends.> and

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sustaining partnerships ,e.g. creating and maintaining productive working relationships and maximi(ing the benefits of addressing an issue with a diverse group of stakeholders..

a/ 91at as3ects o4 your 3ro,ect 2i-- 0e se-4-sustaining and descri0e 1o2 t1ey 2i-continue a4ter 4unding 1as ended+

Section C+ 9or5 P-an /p to 0 pages * Work Plan Template is provided as part of the application package

a/ Com3-ete t1e 9or5 P-an Tem3-ate out-ining t1e o0,ecti.es' e<3ected resu-ts' acti.ities' 3roducts' time-ines' and 1uman resources re!uired 6e+g+ sta44' contract 2or5ers' .o-unteers/+ Section D+ E.a-uation P-an /p to 0 pages ,! pages for the Evaluation Plan Template and ) page for the written description. *n Evaluation Plan Template is provided as part of the application package P-ease re4er to t1e ECommunity-Based Programming Logic Mode-F to 1e-3 you a-ign your 3ro,ectGs e.a-uation 3-an 2it1 t1e Eimmediate outcomesF o4 t1e -ogic mode-+ T1e -in5 4or t1e ECommunity-Based Programming Logic Mode-F can 0e 4ound on t1e ISA 2e0site+

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Please include your own logic model if you have one The budget amount you will dedicate to evaluation # typically 1#)"? of your total budget should be allocated to cover evaluation and monitoring costs. *fter pro3ect activities have finished, many organi(ations find they still need additional time to carry out evaluation activities. @ou may want to ensure that you allocate sufficient time ,e.g. ) to ! months. for evaluation activities at the end of the pro3ect, such as collecting and analy(ing data, report writing and knowledge transfer activities.. $ote: 'uccessful applicants will be reAuired to complete on an annual basis the new Performance Evaluation %eporting Tool ,PE%T. developed by PB*+. 'ufficient resources and time must be allocated to the collection of related information ,up to !? of budget in addition to the 1#)"? above..

a/ Com3-ete t1e E.a-uation P-an Tem3-ate+ )e-34u- ti3s to com3-ete t1e tem3-ate Success7Per4ormance Indicators is information that is collected about a particular process or result that indicates whether or not it has occurred. They are a way to count8measure your progress towards achieving your pro3ect results, and ultimately your ob3ectives. (ata Co--ection describes how the information will be gathered. <nclude the source of the information ,e.g. health professionals, pro3ect participants. as well as the tool or instrument that will be used to gather the data ,e.g. survey or Auestionnaire, focus group, interview.. 0/ Pro.ide a 2ritten e<3-anation o4 t1e e.a-uation 3-an 4or your 3ro,ect+

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Section *H+ &our OrganiIation - /p to ).1 pages - #inancia- administration7management of your organi(ation may be shown by, for example: the existence of an accountant or bookkeeper on staff, the type of financial# related bylaws for your organi(ation, whether there are formal financial policies and procedures for your organi(ations, etc. a/ Pro.ide your organiIationGs mandate7.ision statement+

0/ (escri0e your organiIationGs 5ey acti.ities and main 3rograms73ro,ects+

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c/ Out-ine 21y your organiIation is 2e---suited to underta5e t1e 3ro3osed 3ro,ect 6e+g+ credi0i-ity' re-e.ant s5i--s' interest' e<3erience 2it1 t1e target 3o3u-ation/+

d/ (escri0e your organiIationGs management structure' go.ernance' and ca3acity to carry-out 3ro,ects 6e+g+ sta44 2or5 e<3erience' 4inancia- administration7management' !ua-ity contro- mec1anisms/+

Section **+ Budget /p to 0 pages ,! pages for the budget template and ) page for the written description. * udget Template is provided as part of the application package. <nclude translation costs, if applicable. <nclude other sources of funding, either financial8cash or in#kind. <nclude a confirmation letter from your partners if you have either financial8cash or in# kind contributions.

a/ Com3-ete t1e Budget Tem3-ate+

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0/ Pro.ide a detai-ed 0rea5do2n and e<3-anation o4 t1e 0udget amounts under eac1 category o4 t1e tem3-ate+

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