INSTRUCTIONS

Each section below will contain either a:

a. Drop-down menu, where you can choose one response from a list of options,
b. Box to select from a list of options,
c. Text box where you can type a written response,
d. Text box where you can enter a monetary amount, or
e. Box or line where a hand-written signature and date is required.

Here are a few simple rules to help you:

1. Read the General Guides I & II and the Housing First Guide before completing the form. Housing First Form 2B.1, the Housing First Guide and HPS RFP General Guides I & II are available at http://www.metrovancouver.org/services/regional-planning/homelessness/RFQ-RFO-2016/Pages/default.aspx.

2. All sections must be completed.

3. To choose from a list of drop-down options simply click on the text that says “Choose One”

4. For questions that require text input, simply click on the box and begin typing.

5. Some textboxes have a limit on the amount of text you can type. If you find that you can no longer type additional text, this means you have reached the limit. Try to rephrase your response to be more concise.

6. Do not add any extra characters to a response. For example, if a question asks for a number, do not add any non-numeric characters or you may encounter unexpected results.

7. After filling out the application, please press the PRINT FORM button on the last page. You will need to email a signed copy as part of your submission package. You have to do this before you hit submit.

8. You can go back between pages to change your responses prior to hitting the final submit button at the end of section 2.10. However, once you hit submit after section 2.10 you cannot go back into the form, so please double check all your responses before hitting submit.

9. Once submitted, you will receive an automatic receipt of submission, which does not constitute a complete submission (for full submission requirements see Housing First Guide). You will also receive a PDF copy of your Form 2A application form.This PDF will go to the main contact’s email, so please ensure that the main contact is available to receive this email prior to the submission deadline of July 6, 2016 at 12:00 PM.

10. Print, sign and date section 2.10 of Form 2A and print sign and date the signature section at the bottom of Form 2B.1. Submit both by the posted deadline according to the instructions in the Housing First Guide. These signature pages can be in PDF.

All responses provided are subject to due diligence. Misrepresentation or falsification of facts will result in a decision not to fund.

After consulting the General Guides I & II and the Housing First Guide, if you have further questions, please email Vancity Community Foundation HPS staff at HPSHF2016@vancity.com with the subject line “HPS HF query.”

Personal information in this form is collected and will be used solely for the purposes of the administration of the HPS funding application process. Your personal information on this form is collected and will be protected in accordance with the Freedom of Information and Protection of Privacy Act. For more information, contact Theresa Harding, Manager, Homelessness Partnering Strategy, Community Entity for the Metro Vancouver region, tel: 604-451-6678 or at HPSCE-MV@metrovancouver.org.

Information provided in this form will be stored outside Canada (United States/ Germany); and as such, we are not authorized to collect personal information. If you wish to provide personal information, such as resumes or credentials, please submit as a supporting document according to the submission requirements listed in the guides. Please send to the HPS Vancity Community Foundation email associated with this proposal type.

Please Note:

Some users are experiencing difficulty with the Autofill feature. To find out if Autofill is enabled on your computer, go to this website. Here, you can test your Autofill capabilities, or find out how to turn on Autofill for your browser type.

As an extra step to ensure your work is not lost, please save your answers in a Word document and transfer them to the 2A Online Form when you are ready to submit.

Activity Group

Client Intake and Assessment (Required)

Action

As per CE data reporting requirements, client intake completed within 30 days (Required)

Activity Group

Client Intake and Assessment (Required)

Activity group: Client Intake And Assessment (Required)

Not Applicable For This Section.

Activity Group

Tracking Housing First clients served by the proposed activities at the project level to fulfill funding reporting requirements (Required)

Action

As per CE Data Reporting Requirement, client outcomes tracked (Required)

Activity Group

Tracking of Outcomes (Required)

Activity group: Tracking of Outcomes (Required)
Not Applicable For This Section.

Please Note: You only need to complete this section if you are proposing this activity.

Activity Group: Connecting To And Maintaining Permanent Housing And Accessing Services (Case Management) HPS-Required Indicators For “Housing Stability” Outcome:

# Of Days For HF Clients To Move Into Permanent Housing After Intake
# Of HF Clients Placed In Permanent Housing
# Of HF Clients Who Remained Housed At 6 Months
# Of HF Clients Who Remained Housed At 12 Months
# Of HF Clients Who Remained Housed At 24 Months
# Of HF Clients Who Were Re-Housed
# Of HF Clients Who Successfully Exited From Housing First
# Of HF Clients Who Exit From Housing First For Other Reasons
# Of HF Clients Who Returned To Homelessness

Please Note: You only need to complete this section if you are proposing this activity.

Activity Group: Accessing Services (Case Management):HPS Required Indicators For Social And Economic Outcomes:

Economic And Social Well-Being:
# Of HF Clients Who Had Changes In Income By Income Source
# Of HF Clients Who Started Employment
# Of HF Clients Who Started An Education Or Training Program
# Of HF Clients Who Started A Volunteer Program
# Of HF Clients Who Engaged In Social Participation
# Of HF Clients Who Engaged In Cultural Or Recreational Activities

Note: A role may be partly funded through HPS and partly through another funder - with exception of a medical nurse practitioner, psychiatric nurse and registered nurse, as these roles are not eligible for HPS funding. This section should align with your contributions from other funders and your budget notes.  Be aware of stacking, as HPS will not pay for a role 100% funded by another funder.

Electronic/digital signatures are acceptable. If awarded a contract, original signatures in ink will be required at that stage.

In order for your proposal to be eligible for funding, it must be completed and signed by the official representative(s) of the Respondent organization, in accordance with the organization’s by-laws or other constituting documents. The person(s) signing this form certify/ certifies the following:

a) I/we certify that I/we have the capacity and that I/we are authorized to sign and submit this proposal on behalf of the Organization mentioned in section 2.1

b) I/we certify that the information provided in this proposal and supporting documentation is true, accurate, and complete to the best of my/our knowledge; and

c) I/we certify that the Organization and any person lobbying on its behalf is in compliance with the Lobbying Act, R.S.C., 1985, c. 44 (4th Sup.) and that no commissions or contingency fees have or will be paid directly or indirectly to any person negotiating or securing this request for funding.

d) Metro Vancouver reserves the right not to allocate any portion of the funds mentioned in this Request for Proposals, for any reason.

e) Any decision made by Metro Vancouver to provide funding under this Request for Proposals will not be binding until a legally enforceable funding Agreement has been executed by both Metro Vancouver and your organization.

f) Any funding Agreement resulting from the allocations made under this Request for Proposals will contain a clause stating that Metro Vancouver may terminate or suspend the Agreement at any time, without cause, upon not less than three (3) months’ written notice of intention to terminate.

g) All information contained in this proposal is subject to the Freedom of Information and Protection of Privacy Act, RSBC. 1996, c.165 and the Access to Information Act, R.S.C., 1985, C. A-1.

*Before You Press Submit, Please Print A Copy Of Your Form To Sign. You Will Need To Email A Signed Copy Of Your Declaration Page As Part Of Your Submission Package.*