(Revised 01/01/05

SIX- MONTH REPORTING INSTRUCTIONS

The Six- Month Financial and Progress Report correspond to the first six months of the grant year (Period 1).

Six-Month Financial Report: This report is prepared for the NPO ONLY.

  • The purpose is to monitor your spending pattern during the first six months of the grant year. It allows for a budget revision of the current approved budget if necessary and disbursement of additional funds to cover the expenses associated with the second half of the budget period.
  • Report all expenses incurred during the first six months of the grant year.
  • The Financial Report template is available on the Injury Free web site. (Available at under Resources: Reporting)
  • E-mail the financial report to DiLenny Roca-Dominguez at one month from the end of Period 1.

- 1 of 3-

Six-Month Progress Report: This report is prepared for the NPO ONLY.

  • The purpose of the Six-Month Progress Report and the grids is for the National Program Office to obtain information that will help assess the needs of your site. The Deputy Director will contact each site individually to discuss their progress and to provide technical assistance, as needed.
  • The Six-Month Progress Report consists of a narrative report comprised of summary and detail questions about your program and two reporting grids.
  • The grids summarize the program activities of your site and allow the NPO to aggregate information about the coalition. The gridsare available at under Resources: Reporting. The grids are:
  • Social/Program Grid
  • Technical Assistance Grid.
  • Send a copy of the Six- Month Progress Report, grids and financial report to:

Sally Jacko RN, MPH

Columbia University/SPH

722W. 168th Street, Rm. 1711

New York, NY10033

Six-Month Progress Report: Summary Questions: (1 Page)

  1. What were the project’s objectives and how has the project met them during the first six months of the grant year?
  2. Are there barriers or challenges that are impeding your ability to meet original objectives?
  3. Are there any immediate technical assistance requirements, or specific issues you would like the National Program Office staff to know about?
  4. What are your plans for the next six months?

Six-Month Progress Report: Detail Questions: (Maximum of 3 pages)

Research/Data: Describe how your data are being used in program design and evaluation.

  1. Describe your progress in developing a 3 to 5 year data/evaluation plan. Include in distinctly labeled sections:
  1. Brief overview of new and ongoing data/research/analytic initiatives
  2. List of top priorities with timetable
  3. List of category and number of injuries, current data sources, timeframe, population age range, and geographic area covered
  4. Data manager’s name, experience/training, time commitment (% effort on this project), computerization of data, and software used
  5. Obstacles/problem areas in data and evaluation
  1. Comment on how well your current data and evaluation activities function to prioritize program initiatives and provide timely feedback for improving program effectiveness.

Structure & Planning:Describe how your site is organized and structured.

  1. How is planning managed? Who comprises the planning group? Is there a community advisory board?
  2. How do you ensure buy-in from hospital administration and community members?
  3. How often do the key players and coalition members meet?
  4. What is the timeline for the implementation of current and new programs?

Programs: Describe the injury prevention programs at your site.

  1. What types of programs are currently being implemented?
  2. How do you determine and prioritize which programs you implement?
  3. How are they implemented with community partners?
  4. What challenges are you facing in program implementation?

Fundraising: Describe how the financial sustainability is planned for your site.

  1. Do you work with a development office? If so, briefly describe your relationship.
  2. Have you held any independent fundraising events? If so, briefly describe them.
  3. Do you have any committed supporters (government agencies, foundations, businesses, or individuals who consistently support the program)?
  4. Have you developed a pipeline of sources (e.g. grants to apply for)?

Communications: Describe the support available to help support your site and coalition.

  1. What examples of publications do you have that demonstrates its institution’s support of the Coalition site and/or the national Coalition?
  2. What examples of publications do you have that demonstrates its institution’s commitment to injury prevention?
  3. How can the National Office be more supportive of your efforts to promote injury prevention and/or your programs?

< Prepare the cover page of your report on a sheet of Injury Free Coalition for Kids letterhead stationery. >

SIX MONTH PROGRESS REPORT

Year ______

Date: October 16, 2018

Title of Project:

Purpose of Project:

Project I.D. #

Amount of Support Received

(During this reporting period)

$ $50,000 /

Dates covered by Annual Narrative Report

From 01/01/04 To07/31/04

Principle Investigator / Program Coordinator
Name: Prince E. Pal, MD
Address:XYZMedicalCenter
Pediatrics Department
123 South Street, Rm. 101
New York, New York10000
Tel (XXX) XXX-XXXX
Fax (XXX) XXX-XXXX
Email: / Name: Pro G. Coord
Address:XYZMedicalCenter
Pediatrics Department
123 South Street, Rm. 101
New York, New York10000
Tel (XXX) XXX- XXXX
Fax (XXX) XXX- XXXX
Email:

- 1 of 3-