Application Assessment Tool
Indigenous Community Corrections Initiative 2023

Disclaimer: this document is for reference only and not required as part of the application submission

Application Assessment Form

Level 1 – Initial screening

PSIMS ID #:
Organization Name:
Project Title:
Organization Type: (Select one: Indigenous not-for-profit organizations (on and off-reserve, First Nation, non-status Indian, Métis, Inuit, and urban); or Municipal and other local governments working in collaboration with Indigenous organizations and or communities; or Indigenous governments; or Canadian universities and colleges.
ICCI objective: (Select one: to support the development of alternatives to incarceration; or to provide reintegration support)
Project type: (Select one: Knowledge building (36 months); or Knowledge sharing (12 months); or Capacity building (24 months); or Project implementation readiness (24 months); or Project implementation (60 months and mandatory data collection)
Amount Requested: ($)
Per project budget limit exceeded? (yes/no)
Duration:
Maximum duration exceeded? (yes/no)
Agreement to Privacy Statement (Question 1) (yes/no)
Willing to report to the Government of Canada (Question 2) (yes/no)

Application form: Verify that all sections of the Application are complete

*NO response, the application is deemed incomplete and/or ineligible

Organizational information (Questions 3-9) (yes/no)
Previous funding (Question 10) (yes/no)
Amounts owing to the Government of Canada (Question 11) (yes/no)
Project information (Questions 12-14) (yes/no)
Project activities, relevance and need (Questions 15-19) (yes/no)
Capacity of organization / suitability (Questions 20-21) (yes/no)
Partnership and collaboration (Questions 22-24) (yes/no)
Risk and mitigation (Question 25) (yes/no)
Sustainability (Question 26) (yes/no)
Identification of the project audience (reach) and project beneficiaries (impact) (Question 27) (yes/no)
Detailed budget (Question 28) (yes/no)
Workplan and timetable (Question 29) (yes/no)
Approval (completed and signed original Application) (Section 8 of 9) (yes/no)

Eligibility Part 1:

Recommendation:

Screened by name:
date:

Level 2 – Merit and eligibility

To move on to the third level of review (Review Committee), the application must score 60% or higher in each of the categories.

Scoring Guide

Score the application under each essential criteria on a scale of 1, 3 or 5, where:

1=stated criteria is not met (20%)
3=stated criteria is adequately met (60%)
5=stated criteria is fully met (100%)

Project activities, relevance and need (Questions 15-19)

Capacity of organization/suitability (Questions 20-21)

Partnership and collaboration (financial and non-financial, in-kind) (Questions 22-23)

Risk and mitigation (Question 25)

Sustainability (Question 26)

Identification of the project audience (reach) and project beneficiaries (impact) (Question 27)

Detailed Budget (Question 28)

Workplan and timetable (Question 29)

Level 3 – Review Committee assessment form

Score Guide

1 = poor
3 = adequate with some concerns
5 = very good

Apply one score per section.  Please use the subsequent section (project strengths/weaknesses) for additional comments you may have relating to the evaluation categories.

Brief description of the project

To what extent does the proposed project meet the following objectives?

A. The what and the why

B. The who and the where

C> The how

D. Applicant Capacity and Collaboration

E. Performance Measurement

Final score:

Qualitative assessment: Highlight the key strengths of the project proposal (Maximum of 250 words). This can include qualities like innovation, creativity, commitment, strong connections to community, or whether the project reaches an under-served population or region

Proposed project weaknesses: Highlight the key weaknesses of the project proposal (Maximum of 250 words)

Recommendation:  Check one recommendation below. Your recommendation should be based on both the overall score from Application Assessment Table and your qualitative assessment of the application's strengths/weaknesses.

Do you recommend that the application:

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