Grant Feedback
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Month
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Day
Year
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Worker's Name
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First Name
Last Name
Child's first name & initial of last name
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Town
Age
Reason for Grant
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(If a camp request, please fill out camp info questions)
Total amount of Grant money received
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How did the grant help the child?
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What improvements in the child's behavior did you observe as a result of this grant?
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Did the grant make a difference in the child's life? If so, how?
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