Take Vape Away Grant Program
Hackensack Meridian Health, New Jersey’s largest and most comprehensive health network, is pleased to announce the Take Vape Away campaign, a sweeping $1 million strategy to address the vaping epidemic, which includes grants to school districts and community groups to launch buy-back programs, educational outreach, and other strategies to combat vaping among middle school and high school students.
As part of this initiative, $300,000 in grant funding is available to fund grants up to $7,000 each for local middle and high schools (grades 6-12) and community organizations that serve youth to institute programs to combat vaping. Grant funded programs must address one of the following categories: 1) vaping device buy-back programs; 2) vaping prevention/education; or 3) vaping cessation/behavior modification interventions.
Preference will be given to schools/organizations that have a current school-based health center and/or serve underrepresented populations.
Applications will be accepted through November 30, 2019 and grant funding commitments will be made on a rolling basis through December 31, 2019. Preference will be given to proposals that are fully implemented by December 31, 2020.
I. Eligibility: Your organization satisfies one of the following:
A. Schools that serve children in grades 6-12 and is located in one of these 8 counties: Bergen, Essex, Middlesex, Monmouth, Ocean, Passaic, Somerset, and Union.
B. Non-profit community organization located in one of these 8 counties: Bergen, Essex, Middlesex, Monmouth, Ocean, Passaic, Somerset, and Union and serves children in grades 6-12. Your organization confirms that it has received its Section 501(c)(3) determination from the Internal Revenue Service (the “IRS”) and is treated by the IRS as an organization that is not a private foundation as described in Sections 509(a)(1), (2) or (3) of the Internal Revenue Code (the “Code”).
II. Use of Funds: If a grant is made to your organization pursuant to this grant application, the donation is made only for the purposes included in your application. Your organization confirms that grant funds will not be used for any political campaign or to influence the outcome of any election, and/or to lobby or otherwise attempt to influence legislation.
III. Anti-Discrimination: Your organization does not discriminate based on race, national or ethnic origin, color, religion, age, sex, sexual orientation, gender identity or expression, marital status, family status, veteran status, disability or other characteristic protected by law.
IV. Application Scoring: The overall application will be scored based on the strength of the following sections: Description of intervention: 50%, community need/ underserved population: 25%, sustainability: 15%, and partnerships/ collaborations: 10%.
V. Organization Information:
A. Organization Legal Name (as appears on IRS 501(c)(3) documentation):
B. Organization DBA (Doing Business As) Name if Different from Legal Name:
C. Federal Tax ID Number:
D. Organization Street Address:
E. Organization City:
F. Organization State:
G. Organization Zipcode:
H. Contact Person’s Name and Title:
I. Contact Person’s Address (if different from above):
J. Contact Person’s Phone Number:
K. Contact Person’s E-mail Address:
L. Organization History and Mission Statement:
VI. Project Details
A. Grant Category – While your proposed project may relate to more than one focus area, please
select the one which most applies to your proposed project and outcomes.
- Vaping device buy-back program
- Vaping prevention/education
- Vaping cessation/behavior modification interventions
B. Project Name:
C. Total Project Budget:
D. Total Requested from Hackensack Meridian Health (up to $7,000): Please complete attached budget template
VII. Project Narrative
A. Program Summary (10 points) – Provide a brief, one paragraph statement (no more than three sentences) summarizing the central purpose of the program and who it will serve.
B. Need Statement (15 points) – Describe the scope of the vaping problem in your school and/or community? Maximum of 2,000 characters.
C. Provide a brief (250-500 word) description of the interventions envisioned (10 points). Discuss in general terms the content (including its scope), the general educational approach (lecture format, focus group discussion, team-based learning approaches, or other approaches you are considering), the format (assembly, class room, internet, brochures, etc.) and the number of sessions. If this is school-based, is it a required program? If not, is some additional form of credit offered for those students who participate?
D. Please describe the population that you will be serving (15 points) (e.g, number of youth targeted, age, gender, race, ethnicity, socioeconomic status, geographic location, etc.) Maximum of 2,000 characters.
E. Please describe the overall goal of your project (10 points) (e.g., to decrease the number of youth in ABC school who vape) Maximum of 500 characters.
F. How will you measure the impact of your program (15 points) (i.e., By the end of the one year grant period, 500 7th grade children will have improved their knowledge of the health effects of vaping; During two Vape-Out community events, 1,000 pieces of vaping equipment were turned in) Maximum of 2,000 characters.
G. Will you be involving youth in the planning or implementation of your project? (5 points) If so,
please explain. Maximum of 2,000 characters.
H. Will you be partnering with any other organizations? (5 points) If so, please explain. Maximum
of 2,000 characters.
I. Do you have other funding sources for this project? (5 points) If so, please explain. Maximum
of 2,000 characters.
J. Sustainability (5 points) – Do you plan to continue this program after the grant period has
ended? If so, please describe your plans. Maximum of 2,000 characters.
Hackensack Meridian Health CEO Robert C. Garrett calls on all health networks in New Jersey to launch a major education campaign to warn the public and especially teen about the potential hazards of vaping.