Minni Grant Reminder
A:ORGANIZATION INFORMATION Letter of Agreement #:_______
Agency/Organization:____________________________________________________
Project Name:_________________________________________________________
Address:_____________________________________________________________
Telephone # ( ) Fax #: (____)______________
Summer Mini-Grant Type (check one):
q Enhancement Number of Youth Participants _____
q Apprenticeship Number of Apprentices _____
q Internship Number of Interns _____
Program Type (check as many as apply):
q Health
q Non-Violent
q Educational
q Youth Leadership
q Cultural
q Recreational
q Career Exploration
q City Exploration
q Special Event
q Other:___________________
In the space below please summarize the activities conducted this summer under the awarded mini-grant, including any events. Please attach additional pages of comments, photos, copies of reports or artwork to this report.
____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
B: FINANCIAL INFORMATION (ATTACH ALL RECEIPTS)
Please complete the form below listing items purchased to operate the summer mini-grant program. Please attach receipts to support items claimed. Return completed report no later than September 5, 2011.
TOTAL GRANT AWARD AMOUNT: $_______________
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TOTAL |
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I certify that all of the information provided in this report is true and accurate. I certify that all expenses have been paid for the approved proposal submitted to the Chicago Department of Family and Support Services.
Executive/Project Director: .
Date: ,2011
Please submit narrative and expenditure reports by mail or hand delivered by
September 5, 2011 to:
Lisa Davis
Assistant Director of Youth Services
1615 W. Chicago Ave. 2nd Fl.
Chicago, Illinois 60622
312-743-1287
e-mail: lisa.davis@cityofchicago.org
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