<p>Pyrenees Shire Council Community Grants Program Activity Report Form</p><p>Congratulations on completing your Pyrenees Shire Community Grant Project.</p><p>Submitting this Activity Report is a requirement of receiving a Community Grant and is an important part evaluating the Community Grants.</p><p>To acquit the Community Grant provided to your organisation you need to submit this Activity Report by 30th June in the financial year you received the funding. </p><p>Details of how can be found at the end of this form.</p><p>Any queries about completing this form can be directed to the Pyrenees Shire on 03 5349 1100</p><p>Organisation details</p><p>Funded Organisation: </p><p>Name of person completing this form:</p><p>Grant Round: Round: May is round 1, October is round 2 Financial Year: </p><p>Position: Telephone: Address: </p><p>Email: </p><p>Updated October 2016 Your Project Please could you provide the following information on your project, activity or event: </p><p>*Please use a success rating of: 1 - Highly successful 2 - Successful 3 - Somewhat successful 4 - Not very successful 5 - Not at all successful </p><p>PROJECT NAME LOCATION No Attending SUCCESS Rating*</p><p>Your expenditure Please attach a copy of all receipts to this report.</p><p>Please provide a breakdown of your expenditure of the Community Grant Funding provided by the Pyrenees Shire (including your contribution).</p><p>AREA OF EXPENDITURE Amount e.g. Performers, marketing, advertising etc.</p><p>TOTAL PROJECT COST $ Less Community Grants Program Funding - $ Total contribution by your organisation, sponsors & other $ funding</p><p>Are there any unspent Community Grant Funds? Double click to check box YES NO</p><p>Event promotion</p><p>Updated October 2016 Which of the following activities did you undertake to promote your activities or events? Double click to check box</p><p>Media releases YES NO Flyers / brochures YES NO Interviews with local radio / newspapers YES NO Posters YES NO Direct mail to local groups YES NO Invitation to Ward Councillor to participate YES NO</p><p>Other, please specify below</p><p>Do you have any suggestions or further comments you would like to make about the Community Grants?</p><p>Please forward this form to: Community Grants Activity Report Pyrenees Shire Council 5 Lawrence Street Beaufort Vic 3373</p><p>Or email to: [email protected]</p><p>Updated October 2016</p>