Competitive Grant Evaluation

Grant Overview

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* 1. Please Complete the Following:

Organization Name *

Contact Name/Title *

Contact Phone *

Contact Email *

Grant Fund *

Grant Amount *

Grant Number *

Grant Date

Program/Project Name *

Question Title

* 2. Is the program/project complete?

Yes

No

If no, please explain.

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* 3. Did you impact the number of people identified in your application?

Yes

No

If no, please explain.

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* 4. How many people were impacted to date?

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* 5. Please identify collaborating partners listed in the application

Partner 1

Partner 2

Partner 3

Partner 4

Partner 5

N/A

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* 6. Did you collaborate with the above partners?

	Yes	No
Partner 1	Partner 1 Yes	Partner 1 No
Partner 2	Partner 2 Yes	Partner 2 No
Partner 3	Partner 3 Yes	Partner 3 No
Partner 4	Partner 4 Yes	Partner 4 No
Partner 5	Partner 5 Yes	Partner 5 No

If no, please explain.

Question Title

* 7. Were the allocated grant dollars spent as approved?

Yes

No

If no, please explain.

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* 8. Upload detailed income and expense report for this project/program. Identify any variance from the original budget, as well as detailed accounting of how the FCFP grant dollars were spent. Please include copies of invoices for capital and/or technology purchases.

PDF, DOC, DOCX file types only.