The Patricia Kind Family Foundation
717 Bethlehem Pike, Suite 160
Erdenheim, PA  19038

End of Year Grant Report  (report should not exceed 4 pages.)


Organization: _________________________________________________________________________

Address: _____________________________________________________________________________

Contact Person: ___________________________________ Title: _______________________________

Telephone: ________________________ Fax: _____________________ Email: ___________________

Date grant was received (month and year): __________________________________________________

Purpose of grant or project name: _________________________________________________________

Amount awarded: ______________________________________________________________________

Briefly report on the following. A paragraph on each topic should be sufficient.

 Program

1.  Program goals and objectives. What did you hope to accomplish?
2.  What constituency did you serve?
3.  How many people did you expect to serve or reach? How many did you serve?
4.  Relevant events and activities.
5.  Did the program live up to your expectations?
6.  How did you measure success?
7.  What did you learn from the program? Include examples of successes and shortcomings and explain
     how these will affect future programs.

 Finances

1.  Program budget: ________________________________ Amount raised: ___________________
     If amount raised was less than goal, explain how you revised the program.

2.  Unspent balance of grant, if any: ____________________________________________________
     If entire grant was not spent, explain plans and time frame for spending the balance.

3.  Attach financial statement for the program including all income and expenses.
     If multi-year grant, attach budget for upcoming year.

I certify that this grant was used solely for the purpose designated.

Name & Title _________________________________________        Date: _________________________