Grant Evaluation Form

Grant Evaluation
A Grant Evaluation must be completed and submitted within one month of grant program completion. (unless otherwise stated). Failure to fully complete this report and return it will prevent grantee from future grant consideration. Pleasae note that if the deadline falls on a weekend or holiday, evaluations will be excepted the next business day by 5:00PM.

If you have any questions, please contact jefferson.communityfoundation@gmail.com
Grant Success Information
Grant Received from Which Grant Cycle
Grantee Organization Name:
EIN
Program/Project/Event Title:
Primary Contact

First NameLast Name
Executive Director
If different from Primary Contact
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Is the Project Complete?
If answered "No" above, when is the anticipated completion of the project (a general month, 01 day and year, i.e. 12/01/24 is sufficient)?

MonthDayYear
Project Summary
Please provide a short summary of the project and how the resources from the Foundation helped positively impact the success of the project.
Public Relations
Provide a quote for the Jefferson Community Foundation to use from either the project coordinator, Board, Chairperson, or a beneficiary that describes the success of the project.
Digital Photos:

Please attach 1-5 quality digital photographs of the funded program in action. By uploading photographs, the organization gives permission to the Foundation to use the photos on it's website or in print and electronic materials both now and in the future.
File Upload

Accepted file types: jpg, gif, png, pdf, Max. 50 MB, Max files:5.
Cancelof
Print Materials:
Attach any printed materials relating to your program: press news items, brochures, letters of support, etc.

Max file size: 50 MB, Max. files:5.
Cancelof
Foundation Social Media Comment Opportunity
The Foundation would like to publicly recognize your organization and promote the work we do together to help make our community better. Please provide a quote or two that would help us on this mission. Also include the name of the person that should be given the credit for the comment. **By providing this important information, you are allowing the Foundation to use this for marketing and communication purposes. THANK YOU!
Authentication of Submission
Name of title of person completing this evaluation report

NameTitle
Signature
Date

MonthDayYear
Date
Should be Empty:

Grant Evaluation

Grant Success Information

Public Relations

Digital Photos:

Print Materials:

Foundation Social Media Comment Opportunity

Authentication of Submission