EVALUATION REPORT

Please let us know how the funds we granted were used.

Name of Organization

Project Title

Grant Amount

Report Submitted By

Email

Phone

(###) ###-####

Using the data collected from evaluations of this project, please explain the impact your project and organization has had in our community.

(Please use Quantitative Measures)

What geographical areas were served by your project?

Please explain how your project has impacted Needs identified in the current Community Health Assessment for the Rockbridge Area.

Has the funding you received for this grant been spent? What is the future plan for this project/program?

Please explain how success has been measured within this project.

Please explain.

Does your organization plan to continue this project?

If no, please explain. If yes, what additional funding is needed and what are your anticipated funding sources?

Please send an attachment accounting how the grant funds were used to director@rchealthfoundation.org.

Name

This counts as your signature, ensuring all information in this report is correct to the best of your knowledge.

Position within Organization

Date

MM

DD

YYYY