Letter of Intent Form

Community Details

(Identify the region/state/province)

Name of the Strategy/Initiative/Mobilization Plan:

Explain why your community is seeking Suicide-Safer Community Designation.

  • What steps has your community already taken towards becoming suicide-safer?
  • Why is this designation important to this community?
  • What is your anticipated application date?

Leadership/Steering Committee Member Details

Please provide names, position/title/role, phone number and email addresses for committee members.

Point of Contact Information for Initiative