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Form to submit your project

Thanks for taking some of your precious time to share your success story with the youth community. Here is the form needed to submit a project to the virtual database. The blue stars indicate the information required in order to have your project accepted for posting. Remember... Bringing it to make your project enjoyable to read!

If you prefer, you can fill-in the form in Microsoft Word format and fax it to us at (613)563-2455 or email it to us!

* Required fields

1- Introducing your Success Story

Title: *
Title: *	The title/name of the project, activity, event or initiative you are about to describe.
Start date or duration of the activity: *
Start date or duration of the activity: *	The duration of your project. Example: from March 2001 to March 200; from April 1999 on going; one-day event on April 10, 2000.
Main audience: *
Main audience: *	Who did you aim to reach or involve in your project? Example: students from the University of Toronto; young residents of the Drew Creek region; youth at risk from the local community; people between 15 to 20 years old who want to find out more about North American consumption habits.

2- The Whos and Wheres of your Project

Project leader(s) or contact person(s): *

Who led the project and is(are) able to answer most questions about it?

How many people were involved to make this project come to life?: *

How many people were needed to make this project happen (managers, organizers, volunteers)?

Name and description of organization: *

Was the project undertaken in collaboration with or by an organization, university, high school or any other group? If so, please write the name of this group and describe its mandate. Example: radio show hosted by CHFM 98.8 fm; this project was hosted by an environmental NGO in Victoria called NaturVic. If the name of the organization is the same as the project, write the name in this box.

Street number name (or P.O. box):

City: *

Province : *

Postal Code: *

Telephone number: *

A telephone number is required to facilitate communication between Mosaic and you. It will not be displayed for the general public nor will it be given away without your consent.

Email:

Website address:

3- The Whats and Hows of your Project

What did you want to achieve with this project (goals and objectives)?: *
	What were the main goals and/or objectives of your project? For example: inform students from the University of Moncton about North American consumption patterns; create an education and awareness campaign; organize a major opening event
What did you want to achieve with this project (goals and objectives)?:
	(continuation)
Describe the steps undertaken to achieve your goals and objectives.: *
	Explain, step-by-step, how you accomplished each of your goals and/or objectives. For example: formed a research group to find out more about North American consumption habits; formed a campaign steering committee; drafted a campaign outline; hired a campaign coordinator to organize a major opening event
Describe the steps undertaken to achieve your goals and objectives.:
	(continuation)
What was your initial inspiration/motivation for this project?: *
	What inspired you to start this project? If you did not start this project but know the initial motivation behind it, feel free to write it down. Otherwise explain why you decided to become engaged in this project.
Who helped you accomplish your project?:
Who helped you accomplish your project?:	We want to know about those who helped you financially or by offering any in-kind donations. For example: Refreshments and snacks donated by the local coffee shop; $100 donation from the SunBright Foundation; free room booking at the Drew Park Community Centre
Who helped you accomplish your project?:
Who helped you accomplish your project?:	(continuation)
Say cheese!!!:
Say cheese!!!:	If you have a picture that illustrates your project, please submit it here!
Describe your picture:
Describe your picture:
Say Cheese (again)!!!:
Say Cheese (again)!!!:	If you have a second picture that illustrates your project, please submit it here!
Describe your Second picture:
Describe your Second picture:

4- Lessons Learned

What were the outcomes of your project?: *
What were the outcomes of your project?: *	Did you meet your initial expectations/objectives? Yes or no? Why do you think you did or did not?
We learned: *
We learned: *	What did you learn from this project? Talk about the skills needed and the skills you developed as a leader, a team player or as a group.
Resources:
Resources:	Write down some resources that helped you accomplish this project. Example: books, Internet sites, grandmas secret muffin recipe
For the future we want: *
For the future we want: *	What are the future plans for the project? Do you have any intentions of doing it again? Are you expanding, moving to new places?
Short summary of the project:
Short summary of the project:	In brief, what is the main goal of the organization? The principles activities?