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Community Grant Report Form

Please complete this form to report on the outcomes of your grant.

As a recipient of a Community Grant, you are required to complete this form after your project has concluded per our Community Grant Policy.

Contact name

Organization name if you are submitting this report on behalf of an organization

Street address

Municipality

Province

Postal code

Phone number

What is your organization's status?

non-profit organization

other

charitable organization

The reporting period for this grant is January 1, 2025 to December 31, 2025.

Project or event name

Project or event date

Briefly describe how the project or event benefitted the community if it was a success. If it was not a success, please describe why and outline any contributing factors.

Amount of grant approved

How many people participated in the project or event?

How many volunteers participated in the project or event?

Project financials

Please download and complete Project Financials file, and attach it to you submission.

Project Financials file

Please attach the completed Project Financials file and any relevant documents

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Allowed extensions pdf, doc, docx, xls, xlsx, jpg, jpeg, gif, png, tif

Privacy statement

Information contained on this form is collected under the authority of the Municipal Act. Information collected will be used and managed by the Township of Severn in accordance with the Municipal Freedom of Information and Protection of Privacy Act for general municipal operations. If you require additional information, please view our Freedom of Information and Routine Disclosure Policy.

Please indicate that you've read and understand the above privacy statement

Yes

I declare that this is a full report and account of the project or event that received funding under the Township of Severn’s Community Grant Policy. I am authorized to sign the grant report on behalf of my organization/group.

Yes

Name

Current date

Signature

Clear

Forms

Community Grant Report Form

Project financials

Privacy statement