CIT Indiana Coordinator Mini-Grant Application

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If you have questions about the application please contact NAMI Indiana, info@namiindiana.org

Email *

Indiana CIT Coordinators may apply for funds under the following conditions:

BY APPLYING FOR A CIT INDIANA MINI-GRANT, YOU ACKNOWLEDGE THE FOLLOWING:
• The person submitting this form is a coordinator of a CIT program within Indiana that is recognized by NAMI Indiana as working in good faith toward or is already meeting fidelity with a Crisis Intervention Team program consistent with the Memphis Model and as promoted by CIT International in their Best Practice Guide
• If applying for CIT International Program Certification you must submit a draft of your application to NAMI Indiana for review before a grant would be approved, and if approved you agree to share the results/feedback of your application with NAMI Indiana once you receive your response from CIT International
• If approved to attend a Certified CIT Coordinator Course through CIT International you will provide proof following the course that the designated individual(s) attended the course
• If applying to attend the CIT International Conference you understand this covers only the conference registration fee, and that the awardee is responsible for the costs associated with travel, lodging, food, etc.
• If an award is made as a result of this application, you agree to share the class roster of your 40-hour CIT classes or any CIT in-service trainings you provide, including the names, job titles, agency name, and email address, of anyone attending your class; and that you will use the Pre- and Post-Test provided by NAMI Indiana during your 40-hour CIT classes and return the completed tests to NAMI Indiana for assessment
• The person completing this application is doing so with the knowledge and approval of your CIT committee and any individuals named in this application
• Applying for a CIT Indiana mini-grant does not guarantee approval or payment of funds
• NAMI Indiana may reach out to you for clarification regarding information about this application if necessary

Name of individual submitting this application *

Your role related to your local CIT program *

CIT Program Coordinator

CIT Law Enforcement Coordinator

CIT Mental Health Coordinator

CIT Advocacy Coordinator

On behalf of which CIT program are you submitting this application? *

Are you able to cover the requested cost up front and be reimbursed? *

Yes, our CIT program can cover the cost but we are making this request to be reimbursed

No, this would pose a hardship as our CIT program does not have the means to pay the cost up front

For which CIT Indiana Mini-Grant are you applying? *

Fee for our CIT program to apply for CIT International Program Certification

Fee to take the CIT International Coordinator Certification Course

Costs associated with supporting our CIT program

Costs associated with hosting our community's 40-hour CIT Class

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