Program Application
Ready to prioritize mental health in your school or community? Please complete this application
to bring Our Minds Matter to your school or community.
If you're not ready to start programming but are interested in learning more, please
contact us here.
I am
Please select...
School
Community Organization
Other
If Other, tell us more!
I want to
Please select...
Start a Club
Access to Activities & Campaigns
Other
If Other, what kind of support are you looking for?
Organization or School Name
Site Information
First Name
Last Name
Email
Phone Number
Title/Role
Site Logistics
Please share more details about what you're hoping Our Minds Matter program may be able to achieve within your organization/school
Is there anything else you would like to let us know?
Site Agreements
I will share feedback on program resources and reach in May of each school year.
I Agree
I will not share my unique username and password with anyone outside of my organization.
I Agree
I will not directly or indirectly share any content on the club portal with anyone outside of my organization without written consent from OMM.
I Agree
I will not upload, post, transmit, or store any materials without written consent from OMM.
I Agree
School Information
School Type
Please select...
Middle School
High School
Secondary
Other
School District
Club Sponsors
Please Submit at least 2 Club Sponsors
First Name
Last Name
Email
Phone
Title
Please select...
School Psychologist
School Counselor
Social Worker
Teacher
Paraeducator
Other
If Other,
Student Leaders
First Name
Last Name
Email
Phone
Title
Please select...
President
Co-President
Secretary
Other
If Other,
Club Logistics
Club Name
*Please see
club logo instructions
for more information*
What are your school colors?
Meeting Schedule
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Before School
After School
Combination
Unknown
Expected Meeting Frequency?
Please select...
Weekly
BiWeekly
Monthly
Once a Semester
Unknown
Culture
I want to...
To promote mental health awareness and education within my school
To destigmatize and change school culture around mental health
To provide a safe space for students to talk about mental health issues and challenges
To promote awareness about mental health resources in school and in the community
To advocate for policy/system change that is conducive to student mental health
How many mental health professionals does your school have? (Please only enter a number)
Is there anything else we should know about your current school culture?
Funding Options
Program fees are determined by the level of programming support provided. OMM will schedule an initial meeting with you to discuss program options to best meet your needs and desired level of support.
*Thanks to the generosity of funders and donors, the program is currently available in Fairfax County Public Schools, Montgomery County Public Schools, District of Columbia Public Schools, and DC Charter Schools, with no program fees for the schools.
Do you have the funding to cover any associated program fees?
Yes
No
Maybe
Please provide any additional information about your available budget or financial resources for program implementation
Club Agreements
OMM clubs are a space to connect with peers, raise awareness, share resources, practice coping skills, problem-solve, and build a better school culture surrounding mental health. Please review the club & role agreements to ensure a shared understanding of expecations
By selecting the "I agree" button, I confirm that I understand the expectations for my club as outlined below. If I have concerns about meeting these expectations, I will contact OMM staff to discuss the issue and support needed.
- Collect attendance via sign-in form
- Host at least 4+ club meetings
- Host two recruitment efforts each year
- Use OMM club portal and tools
- Complete surveys, polls, and club forms
I Agree
Shipping
Shipping Address Line 1
City
State
Please select...
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District Of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip Code (#####)
How did you hear about us?
Please select...
Friend/Relative
Colleague
OMM Club Leader, Member or Sponsor
OMM Staff Member
Social Media
Website Search
Partner Referral
Other
By submitting your application, you acknowledge that it serves as a
one-year license
to OMM’s online portal and curriculum. To maintain access, you must submit a
renewal form by May
each school year.
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