Please complete this form and return to: SFES – Grants Program PO Box Suffield, CT 06078

GENERAL INFORMATION Project Leader/Grant Recipient ___________________________ Email:_____________________

Title of Project _____________________________________

Grade Level ________ School(s) _________________Number of Students ___________ Number of Staff __________

$ Granted _____________ Actual $ Spent ______________

PROJECT SUMMARY- Please use a separate paper if more space is needed. 1. Please describe current utilization of grant materials:

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

2. Please describe future plans for utilization of grant materials

___________________________________________________________________________________________________________________________________________________________________________________________________________________________________

3. Are there opportunities to expand utilization beyond current scope?

____________________________________________________________________________________________________________________________________________________________________________________________________________________________________

4. Please note any opportunities or events schedule where we could promote public awareness of the grant :

____________________________________________________________________________________________________________________________________________________________________________________________________________________________________

5. For physical materials awarded -Please indicate the following Responsible party (safekeeping and maintenance):

__________________________________ Location of Materials:

_________________________________________________________

Please use this space to provide any additional feedback on the grant (e.g. outcome versus expectations)

______________________________________________________________________

______________________________________________________________________

Signature __________________________________ Date______________________