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1. Name of District/Club: (Required.)

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2. Name of Grant Project Officer: (Required.)

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3. Telephone of Grant Project Officer: (Required.)

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4. Email of Grant Project Officer: (Required.)

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5. Project for which Grant was received: (Required.)

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6. Amount of Grant received: (Required.)

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7. Details of Participation, ie number of junior boys and girls, adult men and women, senior men and women (over 55 years): (Required.)

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8. Where was the activity promoted: (Required.)

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9. How - list the materials used to promote your activity: (Required.)

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10. How was the VGF given recognition? (Required.)

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11. What were the objectives of the Project? (Required.)

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12. Did you achieve your objectives? (Required.)

Not at all Objective achieved Far exceeded
Clear
i We adjusted the number you entered based on the slider’s scale.

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13. Please provide a comment about why the objective was or was not achieved: (Required.)

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14. Do you intend to repeat and/or develop the event/program in the future? (Required.)

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16. Please list your final budget including all relevant income and expenses: (Required.)

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17. Other comments:

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18. I confirm the information provided is correct (Required.)

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19. Name of person completing the form: (Required.)

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20. Date: (Required.)

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