COSS Grant Criteria

The program request must follow the Mission Statement of the Council on Senior Services…To promote services and benefits of seniors and their caregivers in Northeastern Indiana through a not-for-profit network catering to the aging population.

A maximum total amount will be awarded annually via the COSS grant process. The amount requested and the annual maximum award per organization is not guaranteed. The awarded amount will be determined by the COSS Board of Directors.

The focus of each request should mirror the purposes of the Council on Senior Services. These purposes include providing education, information and advocating for seniors. These purposes are to be accomplished using a grassroots approach. Grant recipients are notified and checks are awarded at the November membership meeting.

In order to continue to qualify for subsequent grant awards, a written report evaluating the project will be required by the COSS Board of Directors by May 1st. There will also be an opportunity to provide an oral report to the general COSS membership at the May meeting.

Deadline for grant requests is October 1st. Grant applications are also available on the website at www.councilonseniorservices.org

Council on Senior Services Grant Application

Date of Request:

Name of Organization:

Address: Phone: Fax:

Email:

Contact Person: Title:

Brief description of your organization (its purpose, services, accomplishments):

Geographic area served:

Number of people served:

Major sources of funding:

Time period the grant covers:

If grant request is for a specific project, please describe (include purpose, need for project, and time period):

Please return the completed application by October 1 to: COSS - Special Projects Committee 709 Clay Street, Suite 101, Fort Wayne, IN 46802

The Problem

Every year emergency personnel respond to hundreds of telephone calls to homes where there is a possible emergency situation, but are unable to gain immediate access. It may be a concerned neighbor or a family member who has a fear for their safety or a 9-1-1 call that is answered, but the caller is unable to speak.

The Solution

Registering in the Safe at Home Emergency Registration System will provide important contact information to emergency personnel before an emergency occurs. The information you give is strictly voluntary, confidential and could save your life. Safe at Home information is entered into the computer system shared by police, fire and EMS services throughout Allen County.

How To Enroll

Seniors or family members may complete the FREE enrollment form and mail it to the address on the form. You or your family member will receive a postcard confirming enrollment and will receive bi-annual calls to update information. For more information, call 260-469-3036 or visit www.fwpd.org/prevention or www.allencountyhealth.com.

Safe At Home Application

Full Name: Date of Birth:

Address:

City: State: Zip:

Keyless Entry System: YES/NO Entry Code: Home Phone: Alternate Phone:

Family Physician: Physician Phone:

Major Medical or Physical Disabilities:

Special Medical Needs:

Oxygen: Vision: Hearing: Walking:

Wheelchair Bound:

Confined to Bed: Transfer with Assistance: Diabetic:

COPD:

CHF: Hypertension: Cancer:

Hospital Preference:

Known Allergies:

Where will you go if you need to leave home in an emergency? (Include Address)