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Contact Us
Please check if you would like to have your information posted on the Age Friendly Communities website -
http://afc.uwaterloo.ca
Project name:
City/Municipality:
Region of Ontario:
Northern region
West region
Central region
East region
Contact information
Name
:
Position/Title:
Organization:
Address:
Email Address:
* Required
Other Organizations:
Funding Source:
(check all that apply)
In kind (from organizations)
Volunteer
Grant,
please specify:
Private sector funds
Funding Scope:
$0 - $1,000
$1,000 - $5,000
$5,001 - $10,000
$10,001 - $25,000
$25,001 +
Start Date of the Project:
Status of the Project:
Ongoing, End date:
Complete, Completion date:
Additional Questions:
1. Please provide a brief description of your project:
2.a.
What aspects of the World Health Organization's Age-
Friendly Community framework are demonstrated in your project? (Please check all that apply):
Housing
Transportation
Social Participation
Respect and Social Inclusion
Civic Participation and Employment
Communication and Information
Community Support and Health Services
Outdoor Spaces and Buildings
2.b.
What aspects of the MAREP Age-Friendly Community
framework are demonstrated in your project? (Please check all that apply):
Principles:
Respect and Support for All Citizens
Access and Inclusion for All
Community Engagement in Decision-Making
Livability
Accountability
Building Blocks:
An Informed Society
An Enabling and Supportive Environment
Personal, Social, and System Connectedness
3.a.
How are you evaluating your project?
3.b.
What strategies for sustainability do you have?
4.
What barriers or challenges did you face in carrying out this initiative?
5.
What strategies contributed to your project?
(ie: tips, lessons learned, best practices etc.)
6.
What new possibilities became apparent while working on your project?
7.
Do you have additional information such as reports, website links or
photos that you would like to share?
Yes
No
If yes, please send files as an e-mail attachment to Rachel Morrison (
rjmorris@artsmail.uwaterloo.ca
).
Thank you for taking the time to fill out this brief questionnaire and sharing your age friendly community story. If you have any questions, please contact Rachel Morrison at
rjmorris@artsmail.uwaterloo.ca
or (519) 888-4567 ex. 35250.
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