State of Utah

STATE OF UTAH Commission on Criminal & Juvenile Justice Utah State Capitol Complex East Office Building, Suite E-330 PO Box 142330 Salt Lake City, Utah 84114-2330 (801) 538-1031

Grant Progress Report 1. Subgrantee: 2. Assigned Grant Number: 3. Report Number:

4. Implementing Agency: 5. Reporting Period (Dates):

6. Short Title of Project: 7. Grant Amount: 8. Type of Report:

9. Name, Title and Phone Number of Project 10. Signature of Project Director: 11. Date of Report: Director:

12. Total Youth Served: Race/Ethnicity Male Female Totals

Black/African American American Indian & Alaska Native

Asian Native Hawaiian & Other Pacific Islander

Two or More Races Hispanic Origin (of any race)

GRAND TOTALS 13. Progress report: (Form will expand)