SHIP 2021/2026 Planning Work Group Application

SHIP 2021/2026 Planning Work Group Application:

Hello,
OSHII is now ready to move forward with the next step for planning for the next five year SHIP contract that will start in the fall of 2020.

We are looking for volunteers to join work groups that will meet four times this fall.

While there are many layers to this plan, we will begin with 3 work groups:

Minnesota Eats (Healthy Eating)
Minnesota Moves (Active Living)
Minnesota Smoke Free (Commercial Tobacco Exposure)

If you are interested in being involved in the planning process and are able to commit to the 4 meetings, please complete this application by noon August 30th. Work Group membership will be announce by September 6th.

Please provide the following information:

Name

Title

Community Health Board

Email

Phone

I am a

Local SHIP Staff
SHIP Partner

I am interested in the following work group(s):
Please rank in order of 1 - 1st choice , 2nd choice, 3rd choice

Topics	1	2	3
Minnesota Eats (Healthy Eating)	Minnesota Eats (Healthy Eating), 1	Minnesota Eats (Healthy Eating), 2	Minnesota Eats (Healthy Eating), 3
Minnesota Moves (Active Living)	Minnesota Moves (Active Living), 1	Minnesota Moves (Active Living), 2	Minnesota Moves (Active Living), 3
Minnesota Smoke Free (Commercial Tobacco Exposure)	Minnesota Smoke Free (Commercial Tobacco Exposure), 1	Minnesota Smoke Free (Commercial Tobacco Exposure), 2	Minnesota Smoke Free (Commercial Tobacco Exposure), 3

I am interested in joining this group because: (Please share 3 to 5 sentences indicating your interests)

As we put the three core content work groups together, we are striving to build teams comprised of state and local SHIP staff representing a variety of perspectives and experience with the core content area (Tobacco, Active Living, Healthy Eating). We will use the following criteria to select teams members for each group. Please also note that a second round of work groups will be tasked with transitioning the guidance from the content work groups into a grant model (TA/Training, funding model, etc). The content work groups will be invited back in the Spring to review and discuss final recommendations.

By participating in the work group I will represent: (Check all that apply)

With travel reimbursement from OSHII, I am able to attend the first meeting in person.

Yes
No

I am able to attend all 4 work group meetings in their entirety.

Yes
No