Developing Minds Denver

Developing Minds Denver | Application
Part 1: General Information

This Cohort experience is designed for organizations that are ready and eager to embark on a journey of self-reflection, action planning, and implementation as they strive to bolster mental health capacity and inclusion within their community. This Cohort requires a full team commitment from participating organizations, as together we take a holistic, 360 degree approach towards building stress-sensitive and trauma-informed ecosystems within all facets of our institutions.
Organization Name*
Enter full organization name
Organization Address*

Street Address

Street Address Line 2

CityState

Zip Code
Primary Contact Name*

First NameLast Name
Primary Contact Email Address*
example@example.com
Primary Contact Role/Title*
Type of Organization*

JCCSummer CampSynagogueDay SchoolReligious SchoolHillelYouth GroupOther
How many staff members are employed by your organization? *

How many teens and/or young adults does your organization serve annually? *

	Number Served Annually
Teens:
Young Adults:

Part 2: Organizational Goals
What is your organization hoping to gain from participating in this cohort experience? What are you hoping to learn? What change are you hoping to see within your organization?*
Briefly describe the ways in which your organization currently supports the mental health and wellness of your staff, participants, and extended community.

Part 3: Participation

Participating leaders are expected to attend the opening and closing in-person cohort sessions, complete the organizational assessment, schedule one 1:1 session with a BaMidbar staff member to review the assessment, and attend three virtual workshops. BaMidbar expects each organization to send a minimum of two and up to three staff members to participate per organization.
Program Dates:
- In-Person Opening Summit: Monday, March 18 from 9:00-3:00pm MT at Rose Community Foundation
- Virtual 1:1 Assessment Review: To be scheduled by organizations between March 22-April 12
- Virtual Workshop 1: Wednesday, April 17 from 9:30-10:45am MT
- Virtual Workshop 2: Wednesday, May 8 from 9:30-10:45am MT
- In-Person Closing Summit: Wednesday, May 22 from 9:00-12:00pm - Location TBD
Participating Leader #1 (REQUIRED)

This individual should be a C-suite employee with decision making power who understands the overall workings of their organization.
Full Name (Participating Leader #1)*

First NameLast Name
Email Address (Participating Leader #1)*
example@example.com
Role/Title (Participating Leader #1)*
How long has Participating Leader #1 worked at this organization?*
Is Participating Leader #1 able to attend the five program dates listed above? If no, please explain.*
Participating Leader #2 (REQUIRED)

This individual should be an employee whose work centers around direct service and program implementation.
Full Name (Participating Leader #2)*

First NameLast Name
Email Address (Participating Leader #2)*
example@example.com
Role/Title (Participating Leader #2)*
How long has Participating Leader #2 worked at this organization?*
Is Participating Leader #2 able to attend the five program dates listed above? If no, please explain.*
Participating Leader #3 (OPTIONAL)

Organizations are welcome to include up to three professionals in the program.
Full Name (Participating Leader #3)

First NameLast Name
Email Address (Participating Leader #3)
example@example.com
Role/Title (Participating Leader #3)
How long has Participating Leader #3 worked at this organization?
Is Participating Leader #2 able to attend the five program dates listed above? If no, please explain.

Do you have any questions about the program or is there anything else you’d like to share with the BaMidbar team?
Should be Empty:

Developing Minds Denver | Application

Part 1: General Information

Part 2: Organizational Goals

Part 3: Participation

Participating Leader #1 (REQUIRED)

Participating Leader #2 (REQUIRED)

Participating Leader #3 (OPTIONAL)