Impact Statement
Provide brief answers to the questions below. You will have the option to upload additional documents at the end of the form. For any questions, contact the Forward Health Foundation office at 218.246.4212.
Name of individual completing this form:
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Were you the original requestor of the grant:
*
Please Select
Yes
No
Please list the original goals of the grant:
*
Do you feel those goals were accomplished? If so, explain; if not, share what you've learned:
*
Approximately how many residents of the Deer River and surrounding areas were impacted by the grant award from Forward Health Foundation:
*
What other entities provided support to this project/initiative:
Is there anything else you'd like the Foundation to be aware of:
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