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* 1. Name of Organization

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* 3. Please tell us about any challenges you have had with this program this past quarter.

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* 4. Please tell us about any successes you have had with this program this past quarter.

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* 5. Please let us know of any challenges you have had in your organization this past quarter (e.g., staff changes, budget management) that may affect your participation in the AoURP.

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* 6. Please provide us with any feedback on how we can best support you.

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* 7. Please fill out the expense fields that apply to your budget for this past quarter.

Dollars spent on...

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