Munlclpal Alcohol ollcy (MA)

lundlng AppllcaLlon lorm

lor more lnformaLlon on Lhe Munlclpal Alcohol ollcy, please revlew lnformaLlon on Lhe 8C PealLhy
CommunlLles webslLe or conLacL krlssl Splnoza aL hccoordlnaLor[bchealLhycommunlLles.ca

AppllcaLlons are due by March 21, 2014 and can be submlLLed elecLronlcally Lo
hccoordlnaLor[bchealLhycommunlLles.ca , by fax 230 336 3119 or by mall 323 CovernmenL SLreeL,
vlcLorla, 8C v8v 0A8.

lease Lype dlrecLly lnLo Lhls form or prlnL and compleLe. ?ou may use exLra pages lf requlred. 1hank
you ln advance for your cooperaLlon
ALlCAn1 lnlC8MA1lCn
CommunlLy: Malllng address:
name of organlzaLlon applylng:
ConLacL person: oslLlon:
hone: Lmall:


WPC lS lnvCLvLu? lease ouLllne Lhe organlzaLlons and lndlvlduals LhaL you wlll need Lo lnvolve ln
developlng a Munlclpal Alcohol ollcy. PlghllghL any sLakeholders you have already conLacLed
regardlng Lhls pro[ecL.
S1AkLPCLuL8S
!"#$%&'()%* ,-#*% '. "&% /,0 1*'2%3"4


?es no


?es no


?es no


?es no


?es no


?es no


?es no


?es no


?es no


Ashcroft Indian Band
PO Box 440, Ashcroft BC, V0K 1A0
Jeff Maxwell
Darcy Robinson Band Administrator
250.453.9154
drobinson@ashcroftband.ca
Greg Blain- Band Chief
Mae Kirkpatrick- Community Health Representative
Nicole Robinson- Social Development Manager
Charlene Pittman- Health Director
Jeff Maxwell- Grant Writer/Researcher

AC1lvl1lLS
WPA1 WlLL ?Cu uC? lease ldenLlfy who wlll be responslble for each of Lhe acLlvlLles llsLed below
and when you anLlclpaLe Lhey wlll Lake place. lf you have oLher acLlvlLles you wlll be underLaklng Lo
develop a Munlclpal Alcohol ollcy Lhen please also llsL Lhem ln Lhe Lable below.
,3"565"7 8*9#:5;#"5':<=:)565)>#( ?%@1':@5A(% B&%:
Crganlze a Munlclpal Alcohol
ollcy commlLLee




CaLher lnformaLlon regardlng
communlLy owned/managed
faclllLles LhaL serve alcohol

ConsulL wlLh Lhe local
communlLy, sLakeholders and
experLs

urafL Lhe Munlclpal Alcohol
ollcy




urafL a Munlclpal Alcohol ollcy
lmplemenLaLlon and supporL
plan




CompleLe an end of pro[ecL
evaluaLlon form






















Darcy Robinson July 2014
Darcy Robinson
July 2014
Jeff Maxwell August 2014
Jeff Maxwell
September 2014
Jeff Maxwell
September 2014
November 2014
Jeff Maxwell
Legal Consultation on MAP
October 2014

CPALLLnCLS
WPA1 MlCP1 8L CPALLLnClnC? lease use Lhls space Lo llsL any poLenLlal or exlsLlng challenges
you see ln compleLlng a Munlclpal Alcohol ollcy (e.g. parLnershlp and collaboraLlon challenges,
lack of capaclLy, eLc.) 1hls wlll lnform Loplcs covered ln reglonal learnlng workshops and lssues LhaL
wlll be addressed durlng group problem-solvlng acLlvlLles.
SuC81
WPA1 SuC81 l8CM 8C PLAL1P? CCMMunl1lLS WCuLu PLL? 8C PealLhy CommunlLles ls
commlLLed Lo supporLlng organlzaLlons Lo compleLe Lhe MA pro[ecL. lease Llck all Lhe supporL
mechanlsms LhaL you wlll need Lo compleLe Lhls pro[ecL.
WPA1 SuC81 LxlS1S lC8 1PlS 8C!LC1? lease provlde evldence LhaL your organlzaLlon supporLs
Lhe developmenL of a Munlclpal Alcohol ollcy. 1hls may be an lndlcaLlon of supporL from local
governmenL ln Lhe form of meeLlng mlnuLes, demonsLraLed resoluLlon of supporL, or leLLer of
supporL from deparLmenLal dlrecLor who wlll acL as a champlon. lease lnclude Lhls wlLh your
appllcaLlon and descrlbe lL ln Lhe box below.
Workbook ouLllnlng Lhe sLeps Lo develop a Munlclpal Alcohol ollcy (MA)
Weblnar/workshop Lo provlde guldance and suggesLlons for Lhe MA developmenL process
Weblnar/workshop on effecLlve communlLy consulLaLlon for Lhe MA
Weblnar/workshop on evaluaLlng Lhe MA and Lhe developmenL process
laclllLaLlon supporL
CLher supporL. lease speclfy:


Lvldence of supporL for Lhe developmenL of a Munlclpal Alcohol ollcy enclosed.

uescrlpLlon:

The Ashcroft Indian Band has never had any policies guiding alcohol consumption on reserve, as such the initial program may be viewed as unnecessary red tape. Also it may be difficult to get community members to engage with the formation of the Municipal Alcohol Plan, as it has traditionally very difficult to get reserve members to contribute to community plans if they are not part of the band council.
All of the above, unfortunately the PDF does not give the ability to check in multiple forms.
Letter from Band Council and Band Administrators in Support

8uuCL1
PCW MuCP WlLL uLvLLClnC 1PL MA CCS1? lease provlde a budgeL wlLh Lhe esLlmaLed amounL
requlred Lo develop Lhe Munlclpal Alcohol ollcy and Lhe source of Lhese funds. lease lnclude ln-klnd
conLrlbuLlons Lo expenses.
Su8MlSSlCn
lease submlL your compleLed appllcaLlon and evldence of supporL for Lhe developmenL of a MA
elecLronlcally Lo hccoordlnaLor[bchealLhycommunlLles.ca, by fax 230 336 3119 or by mall 323
CovernmenL SLreeL, vlcLorla, 8C v8v 0A8 before March 21, 2014.

C1PL8 uL1AlLS
lease be advlsed LhaL a slgned conLracL beL ween 8C PealLhy CommunlLles oclLy and each
successful appllcanL wlll be requlred before release of funds and a flnal reporL (LemplaLe Lo be
provlded) wlll be requlred 30 days followlng Lhe compleLlon of acLlvlLles.
CuLS1lCnS
lease dlrecL all lnqulrles Lo krlssl Splnoza aL hccoordlnaLor[bchealLhycommunlLles.ca or aL
(230) 932-9177.

0'"%:"5#( CD1%:@% ="%E@ C@"5E#"%) F'@" G>:)5:9 !'>*3%
CommunlLy consulLaLlon
Munlclpal Alcohol ollcy CranL
CLher/ln-klnd funds
ConsulLanL fees
Munlclpal Alcohol ollcy CranL
CLher/ln-klnd funds
MarkeLlng and publlclLy
Munlclpal Alcohol ollcy CranL
CLher/ln-klnd funds
MeeLlng cosLs
Munlclpal Alcohol ollcy CranL
CLher/ln-klnd funds
Slgnage for faclllLles
Munlclpal Alcohol ollcy CranL
CLher/ln-klnd funds
1ralnlng for sLaff members
Munlclpal Alcohol ollcy CranL
CLher/ln-klnd funds
1ravel cosL
Munlclpal Alcohol ollcy CranL
CLher/ln-klnd funds
CLher. lease speclfy:


Munlclpal Alcohol ollcy CranL
CLher/ln-klnd funds
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9*#:" *%I>%@"%)

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