Michigan 4-H Foundation » 4-H Grant Report Form

4-H Grant Report Form

Please complete the form below for 4-H Mini Grants, MFB 4-H Excellence in Agriculture Grants, or general 4-H program grant funds received from the Michigan 4-H Foundation.

For programs conducted Sept. 1 – Apr. 30, Report Due May 31
For programs conducted May 1 – Aug. 30, Report Due Sept. 30

Grant Category (check one):*
- Annual 4-H Program Grant
- Michigan 4-H Legacy Grant
- 4-H On-Target Grant
- Collins 4-H Youth Horticulture Grant
- 4-H Educational Garden Grant
- MFB 4-H Excellence in Ag Grant
- 4-H Learning Experience Sponsorship
Project title/4-H program(s) funded by grant:*
Date(s) your program happened:*
Amount of grant*
Project start date*
MM slash DD slash YYYY
County*
Name*
Staff person completing this form.
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Phone
Staff Email*
A copy of this grant report will be emailed to this email address.
1. Description of grant project/program:*
What were your goals? What did you do?
2. Please describe the population served by the funded program:*
(age, gender, ethnicity, ability and geography of participants)
3. How many youth and volunteers were involved with your program? How many hours were they involved?
List
Number of Youth Number of adults Total participants
List
Youth hours Adult hours Total hours
4. What are/were the intended outcomes of this project/program?*
5. Describe how principles of positive youth development were reflected in your project/program.*
For example, outcome is linked to positive relationships, safety, youth engagement, youth directed participation, skill development, diversity and multiculturalism, or service and leadership.
6. How did the program go? What worked out well? What challenges did you have?*
7. Please list any new products or programs that were launched or created as a part of this support.*
Curriculum, website, event, products, etc.
8. How did you involve the media in covering this 4-H project/program?*
9. Is there a story (qualitative) that you can share about the success or impact of this program?*
10. Did you use any evaluation tools with participants to assess the program?*
- Yes
- No
If yes, what did you learn from the evaluation tools?*
Provide a brief summary of participation evaluation forms.
Expenditure Receipts
Please submit all receipts for expenditures which should be reimbursed by this grant. All sponsorship monies are paid by reimbursement from the Michigan 4-H Foundation to the State 4-H Office. You may also choose to submit receipts by email to the CYI fiscal officer. (Please submit JPG or PDF, max file size of 100 MB.)
Drop files here or

Max. file size: 100 MB.
Supervisor email address*
A copy of this grant report will be emailed to this supervising 4-H staff person.
Copies will also be emailed to the State 4-H Office fiscal officer and Michigan 4-H Foundation finance director (Julie Arter).

For programs conducted September 1 – April 30, Report Due May 31
For programs conducted May 1 – August 30, Report Due September 30
CAPTCHA

Number of Youth	Number of adults	Total participants

Youth hours	Adult hours	Total hours