GRANTEE PROGRESS AND FISCAL REPORT

Please return this form no later than 30 days after the end of your program, or by __________, whichever comes first. Your consideration for future funding depends upon completion and timely submission of this form.

NAME OF ORGANIZATION: 
ADDRESS: 
PHONE: 
REPORT COMPLETED BY_____________________________________	DATE: ___________
						(Name & Title)

1.	Please describe briefly the program or service for which your organization received funds.  

2.	Please describe any methods used to recognize or publicize the Windham Foundation’s participation in the funded project.  

3.	Please describe how your funded program reflects the local community needs, involvement and support.

4.	What did these funds provide that would not have been possible for your organization without such aid? 

5.	Please submit proof of expenditures such as receipts, invoices or canceled checks

6.	 Do you have any suggestions for improvement or changes in this grant program?

		

		

	

I hereby certify that _________________________________has performed the service or activity stated in its agreement with the Windham Foundation and has done so during the agreed upon time period and in accordance with the approved budgets.

Signature___________________________________

Title_________________________________________ 		Date_______________