Date:

Name of Organization:

Project Title:

Period that this report covers: ___/___ to ___/___

Grant Amount: $

Instructions: Please limit your report to five pages. Please also provide a complete expense report indicating how the grant award was used. Please email completed report to Program Officer Ninya Loeppky at nloeppky@jmfund.org

1. What were the project’s major accomplishments?

2. List the deliverables and outcomes you proposed in your original application. Describe the activities you carried out, and indicate your level of success in fulfilling each deliverable and achieving each outcome. If you were unable to fulfill any deliverables or outcomes, please explain why.

3. What steps were taken to disseminate the results of the project? [Skip this question if you describe how project results were disseminated in response to Question 2.]

4. How did this project collaborate with or relate to other groups conducting projects with the same objectives?

5. What were the unexpected results or key lessons of your work under this grant? Describe any setbacks you encountered during the grant period.