School Suicide Prevention Plan Grant Application School District Name*Contact Name*Contact's Position*Contact Phone*Contact Email*Please provide mailing address for check (if application approved)*Please attach school district suicide prevention and intervention plan (or brief status report document, if no plan is in place).*Grant applied for (choose one and submit corresponding information below)*Priority will be given to school districts that are (1) in the early stages of planning their district suicide prevention plan and (2) working in consultation with Lines for Life through their Regional School Suicide Prevention and Wellness Coordinators.Student CURRICULUM (Up to $1000)SUPPORT for writing, revising, or implementing plan (Up to $1500)Name of curriculum chosen*(Sources of Strength, Signs of Suicide, etc.)Total cost of curriculum*Amount requested*Additional funding to be covered by*Briefly explain how the curriculum will be used*Type of support needed (substitute pay, staff training, curriculum, other costs)*Total amount requested*Additional funding to be covered by*