Operation Round Up Report Form

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IMPORTANT NOTE:

This is the report form for past recipients of Operation Round Up grants. If you would like to apply for a new grant, please complete the application form linked below. Otherwise, click "Next" to continue completing the report form.

https://form.jotform.com/262426350148151
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Name of organization* This field is required.
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Name of person completing this form* This field is required.
First Name
Last Name
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Phone number* This field is required.
Please enter a valid phone number.
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Email address* This field is required.
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Provide an unduplicated number of individuals served using Operation Round Up grant funds. Estimate if necessary.* This field is required.
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Briefly describe what you were able to achieve as a result of this grant.* This field is required.
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What factors, whether internal or external, have helped or hindered your project? * This field is required.
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Are there any important changes or information about your organization that you want to share with Heartland?* This field is required.
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Did you spend the grant money as outlined in your grant proposal? If no, please explain. (In lieu of a written response, you may submit an itemized list of purchases or expenditures made using grant funds on the following page.)
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Please attach any relevant receipts or other documentation.
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Select files to upload
Max. file size: 10.6MB
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Are there any grant funds remaining? If so, please explain how you plan to use these funds.* This field is required.
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By signing below and submitting the report, you affirm that all information provided is true and correct to the best of your knowledge.* This field is required.If on a phone or tablet, use your finger to draw your signature in the space below. If on a computer, use your mouse or touchpad to draw your signature in the space below.
Should be Empty:

IMPORTANT NOTE: