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ISP IMPACT REPORT FORM
Please use this form to tell us how the grant you were awarded by ISP has impacted your school district, students and community. This report is required to be submitted by each designated organization by May 1st of the year following the grant award year. Completing this form helps us at ISP to provide data which is used to secure future funding. ** This form must be completed before requesting new matching funds**
Contact Name (for report)
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Email
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example@example.com
Phone Number
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-
Area Code
Phone Number
Organization Name
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School District Supported
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How many grant applications did you receive? *if this data is readily available
How many classroom grants were funded?
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Tell us about how the funding was utilized.
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Tell us about how the funding was utilized.
Tell us about how the funding was utilized.
Tell us about how the funding was utilized.
Tell us about how the funding was utilized.
Tell us about how the funding was utilized.
Estimate how many students were impacted by this grant this year?
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About how many students will this grant impact ongoing each year?
If the funded purchase is able to be used more than once.
What is the dollar amount of the grants you were not able to support due to lack of funding? Please do not include grants that you would not have funded even if support was available.
SHARE WHAT YOU'VE LEARNED
In this section, please share pictures and project descriptions so that we can celebrate with you, inspire others, and learn from your experience. *By including media images in this document, you are giving ISP permission to use these items for communications and marketing.
(required) Please upload pictures of any grant funded projects
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jpg, jpeg, mpg, avi, png, gif
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Please describe the pictures
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AGREEMENT
By signing this document, I am certifying that the above information is true to the best of my knowledge and that I am an authorized representative of the designated organization. If you have any questions, please contact Lindsey Riffle. My contact information is lindsey@ispmn.org | 218-208-3435.
Signature
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Date
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