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P a g e 5 o f 1 4 <br />1. Date of Incorporation <br />(Month/Year): August 2014 <br /> 2. Applicant organization’s <br />Purpose/Mission (2-4 sentences): <br />Club Nova provides opportunities for individuals living with serious mental illness (predominately schizophrenia, <br />bipolar disorder, and major depression) to lead meaningful lives of their choice in the community. Club Nova is <br />an intentional, caring community comprised of members and staff who work together as colleagues to directly <br />address the risks of serious mental illness and improve the health, education, housing, economic stability, and <br />quality of life of each member. Club Nova focuses on members’ strengths and potential rather than their illness. <br />3. Please provide a brief description <br />of your organization’s past <br />achievements in carrying out <br />similar projects and evidence of <br />successful record of meeting <br />proposed budgets and <br />timetables (2-4 sentences): <br />We have 36 years of experience providing the full range of Clubhouse Model supports <br />and opportunities. We are accredited through a rigorous process assuring fidelity to <br />the Model. This Model operates on proven standards and is replicated in 300 <br />communities worldwide. The Model is included in the SAMHSA registry for <br />Evidence-Based Practices and received the Conrad Hilton Foundation award for <br />humanitarian work alleviating human suffering. Club Nova is a two-time recipient of <br />the GSK Impact Award for outstanding achievement in improving community health. <br />We have a long-established record meeting budgets and timetables amidst perpetual <br />changes in the NC mental health system. <br /> Yes If yes, is this Yes <br /> organization an <br />4. Living Wage: Does this <br />organization pay permanent <br />employees a minimum living <br />wage? (Yes / No) <br /> Orange County <br />Living Wage <br />Certified Employer? <br />(Yes / No) <br /> <br /> If no, please briefly <br />explain. <br /> <br />5. Schedule of Positions: <br />a. Number of Full-Time Paid <br />Positons: 8 <br />b. Number of Part-Time Paid <br />Positions: 2 <br /> <br />c. Number of volunteers: 22 Average hours <br />worked per <br />volunteer per month <br />6 <br /> <br />Collaborators: Please provide the following information about all significant collaborators and partners <br />whether or not they will be receiving grant funding for this project. Feel free to copy and paste <br />Questions “a” through ”e” as needed if you have more than one significant collaborator/partner: <br /> <br />a. Date of Incorporation <br />(Month/Year): <br /> <br /> <br />The Carrboro Farmers’ Markets are operated by The Chapel Hill-Carrboro Farmers’ Market, Incorporated. February 1983 <br /> b. Applicant organization’s <br />Purpose/Mission (2-4 sentences): <br />The Carrboro Farmers' Market aims to create and sustain a vibrant and innovative market that supports our local farmers and artisans, <br />while extending the benefits of local food to the greater community. The Carrboro Farmers Market works with members to provide the <br />best venue and support to nurture and maintain healthy sustainable farms and artisan-based businesses. The work with customers to <br />provide access to the highest quality fresh local food in an environment that fosters the relationship between farmer, artisans, and <br />customers. And they work with the community to expand the reach of the Market and create a strong local food ethic for our community. <br />DocuSign Envelope ID: A9B18E2F-7835-4086-B808-E21D1F44AE18