Kay Stafford Community Grant

Passionate about improving healthcare?

Kay Stafford Community Grant

The Kay Stafford Community Grant empowers organizations to bring impactful projects to life, honoring Kay Stafford’s legacy.

Application deadline is 12:00 pm on Friday, March 28, 2025. Grants must benefit Trenton Memorial Hospital, with priority for projects addressing 2025 health goals, reducing Emergency visits, improving mental health, or supporting senior care.

Applicants must have a CRA number or partner with a health-related non-profit in Quinte West or Brighton.

Exclusions: advertising, operating costs, construction, taxes, shipping, HR (except speakers), meals, or travel.

For inquiries, contact Lindsay Butcher Dodds at 613-392-2540 ext. 5403.

Please Fillout this Form

SECTION I: APPLICANT INFORMATION

Name of Organization *

Organization Contact Person

Title

Phone *

Email *

Mailing Address

Address Line 1

City

State / Province / Region

Postal Code

Country

Website Link / URL

Facebook Link

CRA#

If CRA# Not Applicable, Partnering Organization (PO):

If Applying with Partnering Organization (PO).

PO Contact Name:

If Applying with Partnering Organization (PO).

PO Contact Title:

If Applying with Partnering Organization (PO).

PO Telephone:

If Applying with Partnering Organization (PO).

PO Email

If Applying with Partnering Organization (PO).

1. Please state the Mission of your organization. *

2. How many people benefit from your organization annually?

3. What is the geographical coverage of your organization?

SECTION II: PROJECT INFORMATION

1. What is the name of your project? *

2. Please describe how your project will: benefit, enhance or improve patient care at Trenton Memorial Hospital. *

3. Does your project meet any of the three priorities? (Please check those that apply.)

Projects that demonstrate preventative health care projects that will divert patients from the TMH Emergency department.
Projects that demonstrate how they intend to fill a gap in the provision of mental health services available in residents in the Quinte West – Brighton communities.
Projects that support health care for Seniors

4. How many people will directly benefit from your project within the Quinte West – Brighton region? *

5. In what community will this project take place, or equipment be located? *

6. Is there a timeline for completion of your project? *

7. How will you measure your success of this project? Please identify 2-3 criteria. *

8. If you are successful, how will you acknowledge the contribution of the Kay Stafford Memorial Fund from TMHF? *

9 . Have you received funding from the Kay Stafford Fund previously? *

Yes
No

10. If the Kay Stafford Fund is unable to meet your request at 100% will you still be able to complete the project?

Yes
No

11. Are there other funders of your project?

Yes
No

12. I authorize that all of the information accuracy, adequacy, validity, reliability, availability, or completeness of any information. (Please Sign) *

Date

Print Name *

First

Last

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