The Pottstown Area Health & Wellness Foundation (PAHWF) Is a 501 (C) (3) Non-Profit Public

WISE Women of Blair County Women Involved in Scholarship and Empowerment

2010 Grant Application Performance Report

Organization Information

Name of Organization: Date: Address 1: Address 2: City: State: Zip: Executive Director: Title: Phone: E-mail: Project Manager: Title: Phone: Fax: E-mail:

Web address: ______Descriptive Title of Project:

Project Budget: Amount Awarded: ______Total Project Budget: ______

Organization Operating Budget Amount: ______

Grant Project Timetable: ______

This report was reviewed by:

______Print - Board Chair Name Print - Executive Director Name

______Board Chair Signature Executive Director Signature

______Date Date

of 4 WISE Women of Blair County is dedicated to empowering women and eliminating racism through collaboration, service and education. Part 1: Project Summary

1. Summary of Project (50 words or less)

2. Project Report. Use Benchmark/ Outcome Report available on the www.centralpacf.org website. List all your benchmarks and outcomes for the funded project and the results based on your evaluation process.

3. Current Findings Describe how the project worked, noting whether it accomplished its purpose, goals and objectives. Note any differences the proposed target population and the actual population served. Describe the methods and approaches used to accomplish the project and the actual staffing and administration needed. Also include collaborative partners for this project, if applicable.

4. Explain How You Leveraged WWBC Funds List other funding sources for this project and amounts received, if applicable.

of 4 WISE Women of Blair County is dedicated to empowering women and eliminating racism through collaboration, service and education. 5. Recommendations for the Future What are your future plans for this project? Briefly describe rationale for ongoing funding, expansion, replication, or termination.

Part 2: Fiscal Report

1. Amount Approved Versus Amount Expended and Balance  Use Project Budget Report  Receipts are not require for submission with final report.  WISE Women of Blair County reserves the right to request any or all financial documentation regarding this grant.

2. Fiscal Narrative  Provide an explanation for line-item budget variances of more than 10%, unless the variance is $100 or less. No more than one (1) page.

3. Reconciliation of Funds  Please submit remaining funds to WISE Women of Blair County unless other arrangements have been approved prior to this report.

Part 3: Data Report Refer to forms: (Access Downloadable “Report Attachments” on website’s “Grants & Giving” page.)  Demographic Report  Geographic Report

of 4 WISE Women of Blair County is dedicated to empowering women and eliminating racism through collaboration, service and education. Copies of the completed Performance Report should be addressed to.

Please provide one (1) hard copy with original signatures and email one copy to [email protected].

Central Pennsylvania Community Foundation Attn. WISE Women of Blair County 1330 11th Avenue Altoona, PA 16601

of 4 WISE Women of Blair County is dedicated to empowering women and eliminating racism through collaboration, service and education.