Fillable Grant FINAL REPORT FORM FY2020 Oregon Cultural Trust (Oregon Cultural Trust)

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Grant FINAL REPORT FORM FY2020 Oregon Cultural Trust (Oregon Cultural Trust)

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Organizational & Professional Development Grant Program - FINAL REPORT FORM
4
FY2020 Oregon Cultural Trust Organizational & Professional Development
Grant FINAL REPORT FORM
Project Contact Name:
Address:
City
Oregon
Zip
Telephone
Email
Organization Name (Fiscal Sponsors accepted only for County Cultural Coalitions):
Federal Tax Identification Number
Executive Director or Board Leadership Name
Title
Email Address
Web Address
Project Information
Project Title
Total Budget for this Project/Activity
Grant Amount Received
Which category did you apply to?
Organizational Development
Professional Development
Briefly describe the project (maximum 150 words)
• If you applied to the Professional Development category, identify the conference or
seminar/workshop/course you attended (include link, if available).
Organizational & Professional Development Grant Program - FINAL REPORT FORM
5
1. Describe the implementation of the project.
(Maximum 250 words)
2. What were key outputs and outcomes of the project? (Maximum 250 words)
3. Was the project effective in improving your organization’s services? Describe
(Maximum 250 words)
Organizational & Professional Development Grant Program - FINAL REPORT FORM
6
Organization & Professional Development Project Budget Form
EXPENSES
Only list direct expenses
Description Expense
1 Project Consultant/Trainer
2 Tuition/Conference Registration
3 Contracted Services
4 Materials/Supplies
5 Materials/Supplies
6 Materials/Supplies
7 Project Evaluation
8 Travel
9 Per Diem and Lodging
10 Other
11
A. Total Expenses
REVENUE
Indicate if planned, pending or confirmed
Description Revenue
12 Applicant (Organization Cash)
13 Business/Corporate Support (source)
14
15 Foundation Support (source)
16
17 County Cultural Coalition Grant
18 Individual/Community Support
19 Other Government Support
20 City
21 County
22 State
23 Tribal
24 Other
25 Grant Amount Requested
26
B. Total Revenue
Projected Total Expense (A) and Revenue (B) must be equal
IN-KIND (noncash contributions and expenses)
27 In-Kind Support
28 In-Kind Expenses
Note: Please provide a budget for the project only, not the operating budget of the
organization.
$ 0
$ 0
Organizational & Professional Development Grant Program - FINAL REPORT FORM
7
(1) Was used for the purpose outlined in the grant award letter and was not
expended for any other purpose.
(2) Information about the organization, project and outcomes of the grant may be used
by the Oregon Cultural Trust
Signature of Applicant
Title
Date
(For Cultural Coalitions only):
If fiscal sponsorship provided by a separate organization
Signature of Sponsoring Organization Representative
Title
Date
Submitting Final Report Form
Please submit the completed Final Report Form, attaching
documentation of Cultural Trust grant recognition materials, via email
to:
ATTN: Aili Schreiner, Manager
Oregon Cultural Trust
Aili.Schreiner@Oregon.Gov
Budget Narrative
Use this opportunity to clarify line items or provide pertinent details about the project budget
– grants awarded, grants proposed or pending, type of significant in-kind donations, special
rates or agreements.
If awarded funds, a final report must be submitted within 30 days of the completion of the
project.
Authorization
The undersigned certifies that they are authorized to represent the organization that received
a grant and that the information contained in this Final Report is accurate.
The undersigned agrees that the grant was awarded to the organization:
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Grant FINAL REPORT FORM FY2020 Oregon Cultural Trust (Oregon Cultural Trust)

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Completed 18 April 2021

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