Grant Report Form

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Grantee Report

A report is due every six month for the next 18 months to cover updates on activities, expenditures and impact.

"*" indicates required fields

1. Organization Name*

2. Project Name*

3. Location*

4. (a) Contact Name for any Report Follow-up*

Prefix First Last

4. (b) Contact Email for any Report Follow-up*

NARRATIVE REPORT

5. Purpose of the Grant ( as seen in Terms of Grant)*

6. Amount of Grant (as seen in Terms of Grant)*

7. Project Start Date*

8. Project End Date*

9. Number of Beneficiaries*

10. Objective 1*

10. (a) Did the project achieve objective #1? If yes, please share indicators and an example of how. If no, please indicate why and how this can be resolved.*

10. (b) Did the target group benefit from objective #1? If yes, please share indicators and an example of how. If no, please indicate why and how this can be resolved.*

11. Objective 2*

11. (a) Did the project achieve objective #2? If yes, please share indicators and an example of how. If no, please indicate why and how this can be resolved.*

11. (b) Did the target group benefit from objective #2? If yes, please share indicators and an example of how. If no, please indicate why and how this can be resolved.*

Additional Objectives (Optional)

11. Objective 3*

11. (a) Did the project achieve objective #3? If yes, please share indicators and an example of how. If no, please indicate why and how this can be resolved.*

11. (b) Did the target group benefit from objective #3? If yes, please share indicators and an example of how. If no, please indicate why and how this can be resolved.*

12. Do you have more than two (2) objectives?

Yes

BENEFICIARY STORIES

Provide 2 to 3 feature stories of impact that include: 1. Beneficiary quotes 2. Images that illustrate the stories 3. Captions to the images

14. Upload Photos (at least 1MB in size each)*

Drop files here or

Max. file size: 256 MB.

Feature Story Upload (optional)

Drop files here or

Max. file size: 256 MB.

14. (a) Feature Story I*

Maximum 500 Words

14. (b) Feature Story II*

Maximum 500 Words

14. (c) Feature Story III

Maximum 500 Words

Caption I*

Caption for image that goes with Feature Story I

Caption II*

Caption for uploaded image that goes with Feature Story II

Caption III*

Caption for uploaded image that goes with Feature Story III

FINANCIAL REPORT

15. Upload Budget report*

Accepted file types: pdf, exe, doc, Max. file size: 256 MB.

16. What was the total estimated/planned expenditure for the past six months? (USD)*

17. How much is the actual expenditure for the past six months? (USD)*

18. How much of the grant funding is remaining (balance)? (USD)*

19. Please share the itemized list of expenditures for the past six months. List item and cost in USD.*

Upload Receipts for Itemized Expenses.*

Max. file size: 256 MB.

Grant Report Form

Grantee Report

NARRATIVE REPORT

Additional Objectives (Optional)

BENEFICIARY STORIES

FINANCIAL REPORT

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