Fillable Town of Vernon Grant Application Fiscal Year July (Town of Vernon Connecticut)

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Town of Vernon Grant Application Fiscal Year July (Town of Vernon Connecticut)

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Town of Vernon Grant Application
Fiscal Year July 1, 2021 - June 30, 2022
RESULT BASED ACCOUNTABILITY DATA
ATTACHMENT B
1 | Page
Agency Name: ________________________________________________________________________
I. Briefly explain how you administered the survey (e.g. by phone, personal interview, clients
fill out survey on their own, other)?
II. What is the time period of the survey data you are providing (e.g. 12 months, 6 months, 3
months, other)?
*Utilizing a Results Based Accountability (RBA) format to measure outcomes is a requirement to
receive funding from the Town of Vernon.
* Please provide a blank copy of the survey that your agency utilizes.
* Please provide RBA data only for the particular program for which you are requesting grant
funds and only for the Vernon clients that you serve in that program.
* Please attach the outcome measurement results from your client surveys.
Town of Vernon Grant Application
Fiscal Year July 1, 2021 - June 30, 2022
RESULT BASED ACCOUNTABILITY DATA
ATTACHMENT B
2 | Page
III. Provide the sum total of Vernon clients served in the program for which you are requesting
grant funds. Provide the total number and percentage of those clients who participated in
the survey.
IV. Please briefly summarize the results for the Vernon clients who participated in the survey.
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Town of Vernon Grant Application Fiscal Year July (Town of Vernon Connecticut)

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Completed 24 January 2021

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