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Fosterville Gold Mine - Community Grants Evaluation Form 

It is a requirement of your successful application to the Fosterville Gold Mine Community Grants Program that you complete and return this evaluation report with 12 months of funding being granted. 
1.Organisation Name(Required.)
2.Project Name(Required.)
3.Postal Address(Required.)
4.Contact Name(Required.)
5.Phone Number(Required.)
6.Email(Required.)
7.Position of person completing this evaluation(Required.)
8.Amount of funding received?(Required.)
9.Over what period did the project occur or when did the event take place?(Required.)
10.Describe the project or event (what happened, highlights, who was involved etc)(Required.)
11.Did the project or event meet its goals and outcomes expected?(Required.)
12.How did the project of event benefit the community and reflect the goals of the Fosterville Gold Mine Social Responsibility Strategy?(Required.)
13.Has the Fosterville Gold Mine Grant been fully expended?(Required.)
14.As a part of this evaluation, you are required to provide an income and expenditure statement. It should reflect the original budget provided by your organisation when it applied for the grant. Please attached a copy of this statement and copies of tax invoices to support the expenditure. A template form can be downloaded here.(Required.)
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15.Where possible include photos of your event / project
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16.Additional file - please upload here
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17.Addtional file - please upload here
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