Lighthouse Grant Application Lighthouse Health & Wellness is pleased to offer a unique grant opportunity for non-profit public service agencies. This grant provides two years of access to a custom Lighthouse Health & Wellness Core app, tailored specifically for your agency or organization. Eligibility is extended to law enforcement, fire services, dispatch units, corrections, EMS, and not-for-profit organizations that support these critical groups. The financial value of this grant is $2,500 per year and includes the build out of the custom app, training, and ongoing hosting and support of the app. Basic Agency InformationOrganization/Agency Name Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Area ServedPlease describe if your organization serves a specific city, county, state, or other regionOrganization/Agency TypePlease select all that apply Law Enforcement Fire EMS/Ambulance Dispatch Corrections Other Other – Please Describe Number of Employees Contact InformationYour Name Your Title/Role in the Organization Contact Email Current Wellness Program InformationWhat wellness programs or resources are currently available to your first responders?Does your organization/agency currently have a CISM and/or peer support team? If so, please describe.Does your organization/agency currently have an exclusive relationship or work directly with any clinicians? If so, how many and what is their role within the organization?Do you or has your organization/agency ever used a mobile app as a part of your wellness programming? If so, please elaborate.What challenges are your first responders facing that this wellness app aims to address?Program Goals and ImplementationWho will be responsible for implementing and managing the wellness app within your organization?How do you anticipate integrating a custom wellness app will enhance your agency's wellness program?The Lighthouse Health and Wellness Core package offers comprehensive support, including app development, administrative training, and resources to facilitate app downloads. To ensure its ongoing effectiveness, your agency will be responsible for maintaining content updates and promoting its use for wellness purposes. Does your program have the necessary time and infrastructure to support these requirements? Please elaborate as needed.Sustainability and GrowthWhat plans do you have in place to ensure the sustainability of the app and its benefits beyond the grant period?Does your organization currently allocate resources, financial or otherwise, for employee wellness initiatives?This app is not available on the public app stores and is distributed privately via Apple Business Manager and Android APK. As such, we require an Apple Business Manager Organization ID Name and Number. We do not need login access to your Apple Business Manager account, just the organization ID number. It is free for your organization/agency to obtain an Apple Business Manager Organization Name/ID. Will you be able to provide us with an Apple Business Manager Organization Name and ID number? This is typically done by your agency's IT team. Yes No Not Sure