Empowering Minds Community Application Form

The Empowering Minds – 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 community’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 community’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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