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PEPSA

818 East Jefferson Boulevard
South Bend, IN 46617
Phone: (574) 234-6024
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PEPSA Grant Report

Mid-year due July 1, 2017
Year-end due February 10, 2017
For the Program Activity Grant Funded by PEPSA

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Please enter full email address (i.e. jane@orgname.org).
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Please enter full email address (i.e. jane@orgname.org).
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Budget
Please use your PEPSA Grant you submitted for reference.
Enter whole numbers only. Do not enter cents, dollar signs, commas or text.

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Below please report expenses YTD which pertain to the PEPSA monies. Do not include your total program budget with other revenue sources. We only wish to understand how you have spent down the PEPSA monies. These figures should match your approved allocation and/or grant proposal.
YTD Expenses:
Enter whole numbers only. Do not enter cents, dollar signs, commas or text.
Enter whole numbers only. Do not enter cents, dollar signs, commas or text.
Enter whole numbers only. Do not enter cents, dollar signs, commas or text.
Enter whole numbers only. Do not enter cents, dollar signs, commas or text.
Enter whole numbers only. Do not enter cents, dollar signs, commas or text.
Enter whole numbers only. Do not enter cents, dollar signs, commas or text.
Enter whole numbers only. Do not enter cents, dollar signs, commas or text.
Enter whole numbers only. Do not enter cents, dollar signs, commas or text.
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Attendance

A representative of my (grantee) program attended Partnership meetings/activities on the following dates:

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Program Progress

On your grant proposal you outlined how you would address one of the Partnership’s recommended actions. In the space below outline specifically how your funded program has made an impact on the “recommended action” you picked.

Include relevant statistics which relate to the recommended action you chose. It is essential that you are detailed on how successful you have been in making an impact on your selected recommended action and as a result helping to reach the outlined goal. Make sure the recommended action matches the one you selected in your original grant proposal.

Include the number of individuals served by your program.

Limit 1000 characters (Approx. 150 words) / characters remaining:

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Section A: All funded programs. Any organization receiving PEPSA monies must address a recommended action from the approved Comprehensive Plan. The following section pertains to your work within these action items. This section of the report must be complete and detailed.

In your approved grant, you stated you would focus on one of recommended actions.

Refer to your grant application and list below:

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Other

Please use this section to provide any other information you deem important or relevant. Please feel free to include short success stores (150 word max), further explanations pertaining to program changes or reasons the program has been altered from the one proposal.

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Any Additional Information

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