Cover Sheet:
1. Report Date
2. Organization’s name and contact information (full address, including mailing address if different, and telephone, fax, and web address)
3. Federal tax-exempt number
4. Contact person’s name, title, and contact information (telephone, fax, e-mail)
5. Costs for administration, fundraising, and program; percent of the total for administration/fundraising; note any special circumstances
6. A history of grants received from the Foundation (including dates)
In a 3-5 page report please describe:
1. Your mission and the issue/need you address.
2. Your programs, services, activities.
3. The target populations, numbers of individuals, and geographic area served.
4. What you accomplished during the grant period. Be specific about measurable outcomes where relevant. (You may include organizational accomplishments, but our main purpose here is to learn about the impact of your program on the individuals served.) You may tell us both about concrete accomplishments in relation to the goals you set, and less tangible accomplishments about which we should know.
5. What challenges/struggles/failures you faced and how you addressed (or plan to address) them.
6. What you hope to accomplish and what your needs/challenges are in the year ahead.
Required attachments:
1. List of current funders (foundation, corporate, major donors) and amount of support
2. Organization’s current budget (please identify fiscal year)
3. 501c3 determination letter
