QI GRANT FINANCIAL REPORT
In this financial report,please provide information on your progress in spending your grant funds.
QI Grant Wave 4: November 1 2014 – April 30, 2015
1st Reporting Period: November 1 2014 – December 312015
2nd Reporting Period: January 1 2015 – February 28 2015
Final Reporting Period: March 1 2015 – April 30 2015
Please report on the period shaded above
Boxes will expand as you type
DATE: ______
1. QI Grant designated site2. Program name
3. Name and title of individual completing this report
4. Amount of funding spent for this reporting period
Please list your expenses in each budget category. If funds were used for consultants, professional development, or tuition, list the names of the consultants, trainings and/or courses and costs associated with each of them.
Budget Categories / In the boxes below, state the amount you were approved for in your application in the designated budget categories / In the boxes below, state amount spent for this reporting period in the designated budget categories / Total amount spent in the designated category for all reporting periods (N/A for 1st reporting period)
Materials/Furnishings
Technology
Please describe your purchases/activities and any challenges you have had in expending the funding in the above budget category.
Budget Categories / In the boxes below, state the amount you were approved for in your application for each designated budget categories / In the boxes below, state amount spent for this reporting period in the designated budget categories / Total amount spent in
the designated
category for all reporting periods (N/A for 1st reporting period)
Consultation
$ / $ / $ / $
Please describe your purchases/activities and any challenges you have had in expending the funding in the above budget category.
Substitutes / $ / $ / $
Please describe your purchases/activities and any challenges you have had in expending the funding in the above budget category.
Tuition / $ / $ / $
Please describe your activities/purchases and any challenges you have had in expending the funding in the above budget category.
Professional Development / $ / $ / $
Please describe your activities/purchases and any challenges you have had in expending the funding in the above budget category.
Other / $ / $ / $
Please describe your activities/purchases and any challenges you have had in expending the funding in the above budget category:
QI GRANT NARRATIVE REPORT
In this narrative report, please provide detailed information on your progress in achieving the goals/action steps that you selected in your QI Grant application.
QI Grant Wave 4: November 1 2014 – April 30, 2015
1st Reporting Period: November 1 2014 – December 312015
2nd Reporting Period: January 1 2015 – February 28 2015
Final Reporting Period: March 1 2015 – April 30 2015
Program name
Please report on the period shaded above
Boxes will expand as you type
- In this reporting period,what progress have you madein achieving your selectedQI Grant goals/actions steps? (Refer to your application’s goals/actions steps.)
Describe each GOAL/ACTION STEP and:
(A) indicate any additions or changes to this goal/action step
(B) detail what you have achieved during this reporting period with the QI Grant funds, addressing what was implemented by whom, where, when, and how
- (A) Did you encounter any challenges in achieving your goals/actions steps? Please explain.
3. Have you applied for a higher BrightStarsrating since you received this QI Grant award? If not, when do you anticipate submitting an application for a new rating? Please describe any obstacles you may encounter with submitting an application?
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