At this time the application does not let you save and come back You must complete the entire form at one time! 1 Start 2 Preview 3 Complete Organization Information Legal Name of Organization * Administrative Office Address * FEIN # * Contact Information CEO/Executive Director * CEO/ED Primary Phone * CEO/ED Primary Email * If different from the CEO, fill out the following for the Program Manager. Project/Program Manager Project/Program Mgr. Primary Phone Project/Program Mgr. Primary Email Project Information Project/Program Name * Grant # Not required. If you know it that's great. If not that's okay. Grant Amount * $ Purpose of Grant * One sentence only please. Date Grant Recieved * MonthJanFebMarAprMayJunJulAugSepOctNovDec Month Day12345678910111213141516171819202122232425262728293031 Day Year20182019202020212022 Year Dates of Project/Program * Total Number of People Served * This includes everyone who participated in your program. Example: 30 children participated in a theater workshop Number of People who Benefitted * This number should be the total number of people affected by your program. Example: 300 audience members who attended the children's theater workshop. Volunteers Utilized * Please list the number of volunteers and what kinds of roles they played. Example: 10 people, they helped with snacks, costumes, and set design Total Volunteer Hours Worked * Noteworthy Statistics This is your chance to list any other numbers that best illustrate your programs impact on the community. Goals and Measurements #1 * Please list the original goal. In one page or less, please explain your ranking. Don't forget that not meeting your goals does not mean you have failed. Often there are positive results from programs that were not originally projected. Measurements #1 * Please rank how closely you met this goal. 1 being somewhat met and 10 being completely met- Select -12345678910 Goals and Measurements #2 Please list the original goal. In one page or less, please explain your ranking. Don't forget that not meeting your goals does not mean you have failed. Often there are positive results from programs that were not originally projected. Measurements #2 Please rank how closely you met this goal. 1 being somewhat met and 10 being completely met- None -12345678910 Lesson Learned * Please share any lessons learned, and/or any recommendations you would make to others working in this area. What would you do differently? Anything else Success Story * Provide a short "human interest story" that helps illustrate the success of the project Second Success Story * Provide a short "human interest story" that helps illustrate the success of the projectPlease upload 2 pictures in jpg or png format in the following spaces. Also download the post-grant budget form here, then upload it below in a doc, docx, or pdf format. In addition upload your organization logo for us to use in publications. Picture 1 * More informationFiles must be less than 200 MB. Allowed file types: jpg jpeg png. Upload Picture 2 * More informationFiles must be less than 200 MB. Allowed file types: jpg jpeg png. Upload Financial Report * More informationFiles must be less than 2 MB. Allowed file types: pdf doc docx. Upload Organization Logo * Upload More informationFiles must be less than 2 MB. Allowed file types: jpg jpeg png. CAPTCHA This question is for testing whether you are a human visitor and to prevent automated spam submissions. Preview
