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Grant Fund Reporting Form

Please fill out this form to its entirety by March 1, 2022. The failure to do so may affect your chapter/state receiving grant funds in the future.

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* 1. Membership Division

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* 2. Chapter or State Name

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* 3. Contact Information
*FBLA-Middle Level & FBLA-High School students please use adviser's contact information.

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* 4. Amount of Grant Funds Received

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* 5. Total Amount of Funds Raised for MOD
*Include any funds raised by your chapter for MOD between March 2021 and March 2022.

Grant Funding Report

All recipients must complete a report detailing their chapter activity in support of the March of Dimes. Activities between March 2021 and March 2021 should be included.

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* 6. Please describe the activity(s) and/or project(s) your chapter or state executed in support of the March of Dimes.

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* 7. Please describe the impact of the activity(s) and/or project(s). This should include:
  • Summary of project and/or activity executed 
  • Outcomes of project and/or activity including amount of money raised & the impact on the community and MOD 
  • Ideas for improvement to project/activity in future years

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* 8. Would your Chapter or State be interested in sharing the activity and/or project that was executed with other chapters and/or states in the form of a article, workshop, or webinar?

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