Final Grant Report

Northwest RC&D Final Report Form

Project Title

County

Organization

Your Senator’s Name

Your Representative’s Name

What does your organization do?

Project Category (choose the category that best fits)

Number of People Served

Number of Events

If your project did not host an event, enter 0.

How did you spend the money?

1. Project Amount Received from Northwest

2. Dollar Amount Received from other Sources (total)?

3. Total Project Value (add lines 1 and 2)

Did Volunteers Donate Time to Project

Yes

Approximate Volunteer Hours

Completion Date of Project

How did the project make an impact in your community? (1 paragraph)

If you have a specific example or personal story from a beneficiary, please share.

Please include the GPS coordinates for your project if at all possible. We’ll be mapping our projects in the future. If this project involved multiple locations, please add additional coordinates in the optional comments section if possible.

Provide a mailing address for reimbursement check.

City

State/Province

Zip/Postal

Add Remove

First Name

Last Name

Phone

Is this form complete and ready for review?

Yes

You must submit Financial Documents in order to be reimbursed! All Photos must be in jpeg format. Copies of cancelled checks and or bank statements and corresponding receipts along with photos can be uploaded. Be sure to black out account numbers before uploading and never upload social security numbers or other compromising information. You can also send by mail to 909 George Wallace Blvd. | Suite C | Tuscumbia, AL 35674

Maximum file size: 52.43MB

Upload all photos of the project.

Maximum file size: 52.43MB

If you are human, leave this field blank.

Provide a mailing address for reimbursement check.

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