GRANT REPORT FORM- COVID19 Community Support Fund

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Please fill out this form completely to share the outcomes of the grant you received. An email address is required so that a copy of your application can be sent to you for your records.

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Overview

Instructions for grant reporting.

In order to assess the impact of our grant making and the continued needs in our community, we ask that you complete this form once you have made all expenditures related to your grant. Renewed funding, if it becomes available, will be based on ability to provide services and documented impact.

1. Name of Organization Submitting Report

2. Name of Grant Report Primary Contact

3. Primary Contact Phone Number

4. Project Name (briefly indicate the purpose of this grant)

5. Summary: How did you use the funding? (please provide a detailed accounting of how funds were spent - feel free to copy and paste budget lines in this field)

6. What did you achieve? (Did the plan go as anticipated or did you make changes and if so, what were they? Also, did you have any lessons learned?)

7. Approximately how many people did you serve?

8. What basic need(s) did you address (check all that apply)?

Food

Yes

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Housing

Yes

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Mental Healthcare

Yes

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Healthcare (including medication)

Yes

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Childcare

Yes

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Domestic Violence

Yes

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Safety

Yes

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Transportation

Yes

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Assistance Paying Bills

Yes

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Other needs not listed here:

9. Where did you offer your services? (select all geographies that apply)?

Onondaga County

Yes

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City of Syracuse

Yes

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