Community Partner Impact Report

Thank you for participating as a 2024 CCHF Community Partner. We look forward to receiving your completed Impact Report detailing how your CCHF grant positively impacted the Canton community. 

DUE DATE: Your Impact Report is due once all CCHF grant funds are expended. Impact Reports received after November 30, 2024 will be ineligible for future grant applications.

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CONTACT INFORMATION
1) Community Partner Organization
 *
2) Contact Person/Title *
3) Phone *
4) Mailing Address *
5) Email *
OBJECTIVES
6) How has your organization met the Objectives outlined in your 2024 CCHF Community Partner Grant Application? Please be specific.
 *
ALLOCATION OF CCHF FUNDS
7) How many Canton residents were served?
 *
8) What specific services did they receive?
 *
9) Were other individuals, outside of Canton, served with your CCHF Grant funding?
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 10) If yes, who were they and how many were there?
11) What will be the impact of CCHF's funding-investment in your organization on the future health, safety and well-being of the Canton community?
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COMMENTS
12) Are there any additional details you would like to share about your CCHF Community Partner experience? 
VERIFICATION

By submitting this Community Partner Impact Report, you certify that all information provided herein is true and accurate. 

Please enter your initials below to submit this application:
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