After your branch has completed your project, please complete this  final report form.

MINI-GRANT REPORT FORM

Directions: Complete this form and complete the last column of the original budget form.

Return to: Arlen Gumbiner, Mini-Grant Chair, 368 Catamaran Court, Venice, FL 34287, preferably 6-8 weeks after completion of your project, or by May 15th. If you have questions call me at 941/426-2005, or e-mail at ajgumbiner65@aol.com

1.        Name of Branch:__________________________________________

2.        Name of Branch President:__________________________________

3.        Phone:______________ e-mail address:_______________________

4.        Address:________________________________________________

5.        Short Term goals-explain how they were met.

6.        Do you anticipate meeting your long term goals?

7.        Attach a copy of the evaluation used and provide a summary of your evaluations.

8.        Attach a copy of any printed media articles.

9.        Attach a copy of your printed program if one was used.

10.     Provide any additional information that you feel is pertinent.