Organization:
Contact Person:

Grant Number:

Date Report Submitted:

Deliverables:

Briefly describe what products this grant bought and whether this is different from what you proposed (i.e., specific products and deliverables such as a strategic plan or a new MIS application).

1.  a. ) Explain whether and how the deliverables helped your organization? If not, please explain why.

b.) Story of impact: Provide a short description of how the funding impacted the life of an individual you serve or otherwise made a difference to your organization. Responses should be 150-350

words (2-3 paragraphs). You are invited to submit photos or images electronically with your report form.*

2.  If you used outside consultation to do this work, were you satisfied with the quality of their work?

3.  What are your plans to advance this work further? How will it be financed?

4.  What did you learn? What would you do differently?

*Stories of impact (section 1.b) are optional and may be shared by The Philadelphia Foundation through any of its communications including but not limited to the web, newsletters or social media. By sharing a story of impact and/or digital photos, you acknowledge that any and all material may be shared with the Foundation’s stakeholders and broader audiences.

5.  Did this funding allow your organization to be more responsive to the communities it serves? Please rate the impact and provide any additional feedback below.

Very Significant
Impact / Significant
Impact / Somewhat Significant / Not a significant
Impact / No Impact

6.  Do you feel that the grant impacted the accessibility and effectiveness of your programs? If not, please explain. Please rate the impact and provide any additional feedback below.

Very Significant
Impact / Significant
Impact / Somewhat Significant / Not a significant
Impact / No Impact

7.  How did the grant impact your organization's ability to deliver on its mission? Please rate the impact and provide any additional feedback below.

Very Significant
Impact / Significant
Impact / Somewhat Significant / Not a significant
Impact / No Impact

8.  Did this funding allow your organization to improve the wellbeing of vulnerable communities in the region? Please indicate to what degree. Please rate the impact and provide any additional feedback below.

Very Significant
Impact / Significant
Impact / Some Impact / Minimal Impact / No Impact

9.  Did this grant support the development and enhancement of services and programs that impact the social and environmental wellbeing of your constituents? Please rate the impact and provide any additional feedback below.

Very Significant
Impact / Significant
Impact / Somewhat Significant / Not a significant
Impact / No Impact

10.  How would your describe your experience with the application process? What changes would your recommend, if any?

11.  Please use this space to provide any additional feedback or comments:

FINANCIAL REPORT
Organization Name:
Grant Number:
Grant Date:
Expenses / Total / Income / Total
Direct Expenses / Grants & Contributions
Consultants (List): / Received (List):
Equipment (List): / Pledged (List):
Applications Pending (List):
Travel
Other Direct Costs: / The Philadelphia Foundation
Contingency
Subtotal Direct / $ / Subtotal Income / $
Indirect Expenses
Staff Time: / Contribution of Organization (if applicable)
1
2
3
Subtotal Indirect / $ / Total Income / $
TOTAL ALL COSTS / $ / SURPLUS (DEFICIT) / $

Please use this space to explain any discrepancies (over 15%) between budgeted and actual expenses:

Signature:

Please save this document to your computer and upload it to the

Grantmaking Services Dropbox.