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EL POMAR FOUNDATION GRANTEE FINAL REPORT AND SELF-ASSESSMENT

PLEASE DO NOT COMPLETE THIS FORM IF THE PROJECT IS NOT COMPLETE OR IF ALL FUNDS HAVE NOT BEEN EXPENDED. Please contact El Pomar's office at 719.577.7061 or 719.577.7060 to request an extension of your final report.

You will receive a copy of your final report via email after you submit this form.
If you prefer to download the form to fill it out click here. Please mail the completed form to El Pomar Foundation 10 Lake Circle Colorado Springs, CO 80906, or fax a copy to 719-577-5702 Attn: Mary Rose Corser

Name

First Name Last Name

Title

Please enter title of person completing report

Email Address Verify Email Address

Telephone #

Date

Date of Final Report

Name of Organization

Please enter the name of your organization

Street Address or P.O. Box

City

Type of Grant

Choose the appropriate grant from drop down list

Purpose of Grant

Grant Amount

Answers to the following questions will allow El Pomar Foundation to better understand the effectiveness of this grant. If any of these questions do not apply to your project, simply mark as "N/A".

IF THIS GRANT PROVIDED ONLY GENERAL OPERATING SUPPORT, PROCEED TO ITEM #9

1. Has the project met your objectives as stated in your grant?

If not, please explain

2. Has the project been modified since your proposal was approved by El Pomar?

If so, please explain how, including name of person who might have been notified at El Pomar.

3. Have actual costs been consistent with estimates?

If not, please describe the reasons for significant variations?

4. When was the project completed?

5. If there were major changes in project completion dates, why did they occur?

6. If you were beginning this program again, are there major changes you would have made?

7. Has El Pomar funding led to support from other foundations, agencies, etc.?

8. How many people do you estimate this grant served and what impact do you think it had on those served?

9. Have all terms and conditions been met as outlined in the grant contract and the grant award letter?

10. If you have an interesting story or anecdote that would help illustrate the impact this grant had and/or the importance of philanthropy to your organization’s ability to address its mission, please take a moment to share the story with us. (Optional)

11. Any other comments?

Thank you for taking the time to make this report on your grant. An El Pomar representative may contact you for further information or to schedule a site visit.

Supporting Financial Documents

Please attach documents by clicking the browse button and then double clicking any file froum your computer that you would like to include. If you have any questions or problems, please call Mary Rose Corser at 719-577-7061.

Additional Files & Documents

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Word Verification

Type the words you see above separated by a space.
Letters ARE case-sensitive.

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