2024/2025 Grant Report
Please complete this report on behalf of your organization within 30 days of the completion of the program (2024 and 2025 grant recipients only).
Name of Organization/Program
*
Organization Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Organization Website
*
Organization Taxpayer ID #
*
Contact Name
*
First Name
Last Name
Contact Title
*
Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Contact Email
*
example@example.com
Type of Grant
*
Art
Assistive devices and equipment
Dance
Drama
Individual
Music
Recreation
Grant Time Period
*
Fall/Winter
Spring/Summer
Program Completion Date
*
-
Month
-
Day
Year
Date
Were you able to obtain your goal?
*
Were you able to meet the needs of the population you served?
*
What measures did you use to evaluate your program for success?
*
Please share data and/or forms and comments as applicable.
Did you use the funding to (check all that apply):
*
hire teachers/therapists
rent space
advertising
purchase materials
start a new program
increase enrollment
miscellaneous (explain below)
Did you use the funds as applied for and if not, please explain how funds were used:
*
Please upload or provide website links to one or more of the below materials which may be used by the Theresa Foundation:
*
press coverage
photo(s)
video(s)
newsletter
promo material(s)
File Upload
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Website Links
Grant Report Authorization:
*
I certify that this application is true to the best of my knowledge.
Electronic Report Authorization:
*
By sending this report electronically to us acknowledges your certification to the accuracy of this report.
Signature
*
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