Empowering Minds Community Application Form

The Empowering Minds โ€“ Community Application is designed for Agricultural Societies and community partners interested in hosting the Empowering Minds initiative. This form gathers key details about your organization, your communityโ€™s readiness, and the supports you have in place to deliver a meaningful and lasting mental health program. By completing this application, you will: - Share information about your community, organization, and leadership capacity. - Highlight the mental health challenges and needs most relevant to your region. - Confirm logistics such as venues, outreach capacity, and ability to host a community supper. - Identify the outcomes you hope to achieve and your plan to sustain impact beyond the initiative. Your responses will help us understand your communityโ€™s strengths, needs, and readiness to participate. Please answer as fully as possible while keeping your responses concise.

Step 1 of 3

Section A

Community & Organization Information
Contact Person's Name(Required)
Contact Person's Role
Contact Email Address(Required)
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