CHASM Application - Teams [ENG/FR]

If you are looking to have your community health initiative be supported by CHASM Incubator - you've come to the right place - click next!

Deadline : Tuesday, January 31st 11:59 PM (EST).

Note: You can save your application before submitting and come back to where you've left off.

Si vous souhaitez remplir ce formulaire en français - cliquez-en haut.

Were you looking to get involved as a member of the CHASM incubator executive team? - Click here

What is CHASM?

CHASM Incubator is a social catalyser supporting sustainable health solutions for Montreal communities. Selected applicants receive up to $1000 in funding, are paired with a wide range of experts in healthcare and business, and receive training on impact and value. At the end of the curriculum, graduating projects will have gone through four different phases and will be up and running within the communities they serve. Several of our teams have gone on to receive grants from organizations such as the Canadian Medical Association, and have received awards such as Forces Avenir!
Please send us an e-mail and let us know you are applying! We can set up a zoom session to help you with your application and answer any questions you may have about the CHASM programme! Info@chasmincubator.com
CHASM Incubator Program Details:

Streams - We have two streams at CHASM incubator. 1) Needs Asessment 2) Impact stream

1) Needs Assessment Stream - *Not Currently Recruiting* - follow us on facebook for a call for projects in this stream in early winter 2023. This stream focuses on exloration and qualifying the needs of a underserved montreal community. The goal of this stream if for the participants to understand the needs of the community, and start to develop solutions in partnership with community. An example of a team that completed this stream is Art for Elderly.

2)Impact Steam *Currently Recruiting* - This stream is for teams that are just getting started or are well on their way of tackling a health inquality in Montreal. Some examples of previous projects incubated by CHASM are Monthly Diginity, Supporting Young Black Students (SYBS), and Collaboration Interprofessionnelle Montrealaise Etudiante (CIME)

Here is what you can expect from our Impact Stream Program:
1. Timeline
  1. Mid November - applications close
  2. November to December - selection of the projects for incubation
  3. January - May - Incubation Program
2. Time Commitment
  1. CHASM Incubator requires a commitment of 30-40 hours between January - June mainly for workshops, and time required to work on deliverables
  2. Hours can be shared by members of your team
3. Deliverables
  1. Empathy Map
  2. Business Canvas
  3. Impact Gaps Canvas
  4. Evaluation and Impact Plan
  5. Final Pitch
4. Funds
  1. All teams will receive financing to help the projects become a reality
5. Mentorship
  1. All teams will benefit from mentorship from a leader in their the teams field / subject of interest
Please complete this form to complete your appplication for the CHASM programme. If you have any questions, don't hesitate to reach out to info@chasmincubator.com.
Application Evaluation

Projects must target a local, marginalized population and their social determinants of health. Applications will be scored on their ability to co-create within their community, their sustainability, and their measurability. Research projects or various forms of data collection (while important!) may not be an ideal fit - if you think your project is in this category - reach out to us to learn more about our 'Needs Assessment Stream'.
My project addresses a health inequity in MontrealMy project works with an underserved populationI have a relationship with a community organization, or I am actively seeking a community organization partnerAt least one member of my team is a McGill student / trainee or a recent McGill graduateMy project is evidence-informed, and we are addressing an established need from the community

Contact Information
1. Name of Project Lead. This is the person with whom the CHASM Incubator will be corresponding.*
2. Email Address:*
3. McGill Program and Year of Study:*

Impact Focus Stream 1/3

Tell us about your team
[My team and] I have already established a relationship with a community organization that serves a marginalized population.I have sent a letter of support from a staff member of said community organization, detailing my relationship with the organization or population and the validity of the identified need to info@chasmincubator.com.
Ideation phaseVery early stage (less than 1 year old)Early stage (1 to 2 years old)
Currently a one-person showAlready fully-establishedLooking to recruit
4. How many people are on your team?*
5. Describe your project’s executive team and the qualifications and experience of each member. (Max 100 words per person)*
6. Do you, or any members of your team identify as a part of an underserved population? (Optional)

Impact Focus 2/3

Tell us about your project!
7. Please describe your target population and the need your project will address. How was this need discovered or identified? (Max 200 words)*
8. Please describe your project or idea. Describe the health/healthcare benefits your project will entail. What are three milestones you would like your project to achieve while in the CHASM Incubator? (Max 200 words)*
9. Explain the rational and evidence behind the intervention to address your selected health inequity. (Max 200 words)*
10. What is the name of the community organization you are working with ? If you don't yet have a community partner, what is a name of an organization that you would like to partner with? *
11. Community organization contact name and e-mail (or telephone) - Please remember to send us a letter from this organization confirming your relationship at info@chasmincubator.com, or the below.
Reference letter upload

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Impact Focus - 3/3

Tell us a bit about why you are interested in the CHASM Incubator program
12. Why are you applying for a spot in the CHASM Incubator? What aspect(s) of CHASM (the funding, mentorship or social accountability and sustainability curriculum) will be most useful to your team? (Max 200 words)*
13. What background or expertise would your ideal mentor have? (Max 100 words)*

Funding

Please provide us with some more information about your funding needs
How much funding are you requesting (Max $1000)?*
You can find a simple template for a buget here - CHASM BUDGET TEMPLATE
Upload a rough budget for your project to justify the above. Include expenses and other projected sources of income.*

Allowed file extensions: .xlsx, .xls, .doc, .pdf
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Mentorship

Provide us with some information to help us find you a suitable mentor
Briefly describe an ideal mentor for your project (what would you like to get out of the mentorship program)
Provide 3 names of potential mentors that you would be interested in working with from the McGill community

Do you have any questions or comments? (optional)
You made it! This is the end of the application. Thank you for your passion!

Should be Empty:

What is CHASM?

Contact Information

Impact Focus Stream 1/3

Impact Focus 2/3

Impact Focus - 3/3

Funding

Mentorship