Grantee Final Report Form

Organization Name:

Grant Period:

1.A brief description of the project and the current status. Describe any changes from the original proposal.

2.Were the objectives set forth in the request met? Yes/No (circle one) List original objectives and actual results.

3.If objectives were NOT met, indicate the measurable impact that the project had on the need described in the request and explain circumstances that led to them not beingmet

4.Describe any unanticipated benefits and/or challenges encountered during the course of this project.

5.If your project was identified as “Environmental”, list the specific category, location, quantity, activity, and/or typeof area(s) impacted, e.g.Habitat restoration along 26 miles of the Muddy Boggy River beginning 4 miles north of Bridgeport and ending .5 miles south of Trenton City impacting an estimated 47 species of wildlife, two of which have been identified as an endangered species by both the State and Federal Governmentorrestoration and maintenance of an additional 600 acres of Prairie lands in North Fairmount Valley including the reintroduction of four plant species that were previously indigenous to the area.

6. If the work of this project is to be continued, how will it be funded?

7. Did your grant from Spirit Mountain Community Fund help you leverage additional support? Yes/No(circle one) If yes, please list other supporters and funding amount below:

8. During the previous 12 months has there been any change in the diversity among your organization’s employees and/or Board of Director’s membership? i.e.In the past 12 months our Board of Directors ethnic and/or social minority membership has increased from 15% to 45%, we now have a gender balanced board and have adopted a formal Diversity Statement/Policy.

9. Financial Report: An accounting of how Spirit Mountain Community Fund grant funds were expended, using the budget template submitted with your application-complete SMCF Actual Expenditures Column (you may attach your original).

Demographic Information

Please note that N/A is not an acceptable response.

List the number of individuals served within the following categories: (unduplicated count)

Numbers served per county

Number served by ethnicity

If your project was identified as “Educational”, list the number of individuals served within the following groups:

To submit the final report, there are 3 different options to choose from.

1)Email the completed report to Louis King at

2)Mail a hard copy of the report to:

Spirit Mountain Community Fund

9615 Grand Ronde Rd.

Grand Ronde, Oregon 97347

3)Fax a copy of the report to:503-879-1402

Please do not submit your final report without all of the requested data. N/A is not acceptable as an answer to any of the data collection requirements. Please do not submit photos, CD’s, brochures or other materials that are not specifically requested.

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