York County Veterans Outreach Report on Funding, Required Within 6 Months of Receipt of Funds

This form is to be completed within 6 months or less of receiving grant funding from the York County Veterans Outreach and must be submitted before any additional funding requests.

Our Mission: York County Veterans Outreach assists veterans and their families, to identify and access resources, services, and programs to meet their short- and long-term goals.

Our Grant Program: is designed to provide financial support to initiatives and organizations deemed capable of generating broad and substantial benefit to York County veterans and their families.  

Important Note: We will not be notified when this form is complete.  You must alert our administrator via email when you have finished this form at cstorm.ycvo@gmail.com or you can print this form and submit it via the mail to: 

York County Veterans Outreach

PO BOX 3627

York, PA 17402

Questions?  Email or call 717-978-3049

ALL GRANT FUNDS ARE TO BE UTILIZED FOR YORK COUNTY VETERANS AND/OR THEIR FAMILIES.

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1.) Today's Date *
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2.) Name of Entity *
3.) Your Name *
4.) Email *
5.) Phone *
6.) Dollar Amount Received from YCVO *
7.) Date funding was received. *
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8.) Has all the funding been utilized? *
9.) How long did the funding last? *
10.) How many individual York County veterans were served with the YCVO Grant Funding? *
11.) Were any family members of York County veterans served with YCVO Grant Funding? *
12.) Were funds from the YCVO Grant used for anyone who is not a York County veteran and/or family member? *
12a.) If you answered, "Yes", please explain.
13.) Were all York County veterans served with the YCVO Grant Funding verified with the York County Department of Veterans Affairs? *
13a.) If you answered, "No" please elaborate how you confirmed their credentials and any other pertinent information.
14.) If legally permitted (in-regards-to HIPPA and other Privacy Laws) and requested by the YCVO Board at the time of your Grant Disbursement, please provide a list of the names of York County veterans served with the YCVO Grant Funding.
15.) Were there any changes to how the YCVO Grant Funding was utilized that differed from the original intention listed in the YCVO Grant Application? *
15a.) If you answered, "Yes" please explain.
16.) Since receiving the YCVO Grant, has your program become self-sustaining financially? *
16a.) If you answered, "No" do you plan to return to the YCVO with an additional grant funding request? 
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17.) If you intend to reapply for additional YCVO funding, please detail your needs and future plans for possible grant requests.
18.) Privacy: Submission of grant reporting will not be considered confidential in nature.  If information within the reporting needs to be kept private, please indicate on the application what documents and/or information need to remain private.

19.) Is there anything else you wish to share with the York County Veterans Outreach Board of Directors?
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Very Important:  Before Submitting this Form, Print it for your records.  Once you click the Submit button below, the form will disappear and you will not have access to it for printing or additional edits.

Additional documents, photographs and more can be mailed or email to:

York County Veterans Outreach
Attn: Cassandra Storm
PO BOX 3627
York, PA 17402

Or Email cstorm.ycvo@gmail.com 
Questions?  Email or Call 717-978-3049

When Finished, Click "Submit" Below and Email cstorm.ycvo@gmail.com that it has been completed.
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