Community Support Agency Grant Program
Provide proposed Performance Measures for the agency for the upcoming fiscal year. Include at least
one Outcome Measure. Submit this form by July 30 along with a signed Conditions of Grant Award form,
the Adopted Budget Form, and the First Quarter Payment Request form.
These are some definitions and examples of performance measures that may be helpful.
Workload Measure (How much did we do?)
Number of customers served
Number of activities held
Efficiency/Effectiveness Measure: (How well did we do?)
Customer satisfaction
Cost per customer
Percent of actions that are timely and correct
Outcome Measure: (Is anyone better off?)
Change in behavior, circumstances, results due to services
Agency Name: ________________________________________________________________________
Contact Person: __________________________________
Phone: _________________ Email: ___________________
Performance Measure
Prior Year Goal
Prior Year
Current Year
_________________________ ___ _________________________________ ___________
Signature of Authorized Official Typed Name of Authorized Official Date
Submit this form in hardcopy or electronic format to :
City of Newport News
Department of Budget & Evaluation
2400 Washington Avenue, 9th Floor
Newport News, VA 23607
(757) 926-8733
click to sign
click to edit
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