2024 Ginny Gives Awards Application

2024 Ginny Gives Awards Application
Estimated time to complete: 45 minutes

Through its Ginny Gives Awards program, the Dementia Society of America (DSA) is proud to recognize programs and activities that enhance the quality of life for those living with Dementia, their caregivers, and the public. Awards are given in the following categories: music, graphic arts, dance/movement, touch/sensory stimulation, and many others.

PLEASE READ THE PROGRAM DETAILS AS WELL AS THE TERMS AND CONDITIONS NOW (LINK BELOW), AS YOU WILL NEED TO CERTIFY YOUR UNDERSTANDING AND ACCEPTANCE AT THE END OF THIS APPLICATION.

Here's the link www.dementiasociety.org/ginny-gives

Judging will be done by the DSA Board of Directors and the DSA Advisory Council.
- OPEN SUBMISSIONS: OCT 10, 2024 - NOV 10, 2024 AT MIDNIGHT ET.
- AWARD WINNERS WILL BE NOTIFIED BY EMAIL BY DEC 2, 2024.
- AWARD WINNERS WILL BE REQUESTED TO BE REPRESENTED AT THE DEMENTIA SOCIETY'S ANNUAL VIRTUAL (ZOOM) RECOGNITION NIGHT ON TUESDAY, DEC 10, 2024 AT 7:30 PM ET.
Contact Name:*

First NameLast Name
Organization/Business Name:
Address 1:*
Address 2:
City/Town:*
State:*
Zip/Postal Code:*
Country: *
Phone Number*
Please enter a valid phone number.
Email Address:*
Applicant's Position/Title:*
How did you learn about the Ginny Gives Awards?*
Employer Identification Number (EIN) - if applicable
NONPROFIT? US/Canada status:*

YesNo
WHERE? Choose where you provided program/activity...*

Dementia Care Adult Day ProgramAssisted Living Community with Dementia CareSkilled Nursing Community with Dementia CareCCRC with Dementia CareStand-alone Dementia Care CommunityDementia Support GroupDementia-Aware/Friendly Community InitiativeNon-Medical Therapist, e.g., Music, Art, Movement, etc.Other
WHAT? Choose one program/activity category...*

Music (all forms)Graphic arts (all forms)Movement/danceSensory stimulation (not audible/visual, e.g., touch)Creating writingSongwritingTheatrical worksMotion picturesDementia awareness/friendly initiativesResearch (DSA's Dementia QUEST Award)Technical (digital/physical) innovations (DSA's Dementia SMART Award)Excellence in person-centered care (DSA's Dementia CARER Award)Other
WEBSITE?
HEADLINE? In ten words or less, create a headline/title that quickly describes the program or activity that you or your organization provided/implemented during 2023-2024.*
HOW? In 300 words or less, please describe the OBJECTIVES (the why, and the how) of the program or activity you implemented, and how you measured success (surveys, or other metrics).*
WHO? What was the numerical impact? In essence, how many individuals living with Dementia did you positively impact over the course of the program? Example if you have an art-making program for 10 people that repeats for the exact same people 4 times over the course of a month, the total # impacted is 10, not 40. Your answer must be a whole number.*
WHAT? In 300 words or less, please describe the quality-of-life OUTCOMES of the program or activity you implemented, and what did you measure (surveys, or other metrics). You will provide support for your answer in the next field.*
OUTCOMES IMPACT LINK: You must provide a link to an online document, video, or Dropbox/Google folder to support your statements of NUMERICAL and OUTCOMES impacts. Examples: satisfaction surveys, interviews, images, video, metrics, etc. *
WHEN? First date of the program/activity...*

MonthDayYear
Date
END? Last date of the program/activity...*

MonthDayYear
Date
CONTRIBUTORS? If you employed one or more third-party contractors, i.e., performers, vendors, booking agents, and the like, to deliver your program/activity, please provide their name(s), best phone number(s), email(s), and website address(es).
PROMOTE DSA? Please describe the ways in which you or your organization can help promote and/or support the Program and/or DSA.*
NEWSLETTER? Do you agree that we may add your email to our monthly eNews?*

YesNo
MESSAGE? This is a field where you can send us any special messages and we will do our best comply/respond.
ENTER YOUR FULL NAME. Please enter your name here before you answer the next certifying question.*
CERTIFY. Do you certify that you have read the 2024 Ginny Gives Awards Terms and Conditions and have abided by them? Do you certify that the Program was primarily intended for those living with a diagnosis of some form of Dementia? Do you certify that all of the information provided is true and accurate to the best of your ability? Find a link at the top of this application to access the Terms & Conditions, if you haven't done so already.*

YesNo
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