Grant Summary

PCCRA Grant Summary

Instructions

The PCCRA Board requires any organization receiving grant funds to complete and return the following grant summary within 12 months of receiving the grant or when the funds are spent, whichever comes first. Any funds remaining unspent after 12 months must be returned to PCCRA.

Grant Summary Form

* are required fields

Grant Summary

Organization Name

First Name

Last Name

Quarter/Year the grant was received

Amount of grant

Itemize expenditures listing how the money was spent and the cost. (How money was spent/Amount - one per line)

Total Expenditures:

Remaining Grant Funds:

How many people were serviced with this grant money?

How were your services improved?

Your Email:

Authorized Name:

Signature (using mouse or finger)

Clear

If you are human, leave this field blank.

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