Harmon Arts Grant Reporting Form

2. PLEASE READ

   Submit a completed report form within 90 days of the conclusion of your grant-funded event(s).

   Submit a completed report form within 90 days of the conclusion of your grant-funded event(s).

4. Organization Information

6. Name of organization *

7. Phone Number *

9. Address*

10. City, State, and Zip Code*

12. Contact*

    PERSON RESPONSIBLE FOR THIS PROGRAM OR PROJECT (Please list program contact and NOT grant writer unless they are the same person.)

13. Contact phone number *

14. Contact e-mail address*

16. Name of event/program*

17. Grant amount *

19. Date of program/event*
    Date of program/event

20. Number of attendees*

22. Please provide a brief description of the actual event*

    1,000 characters maximum

24. Were there any modifications to the event that affected how grant dollars were spent? If so, please explain*

    500 characters maximum

26. Expenditures (itemized) for the event*

    List all expenses paid by grant funds. 500 characters maximum

28. How did you recognize the Harmon Arts Grant Program’s contribution to your event?*

    If applicable, please attach copies of advertisements, programs, posters, news releases or media coverage of your eventacknowledging the contribution of the Harmon Arts Grant Program.

29. Upload any necessary attachments

31. Electronic Signature*

    By my electronic signature, I certify that the above answers are true and that all expenditures reported (or payments requested) are for appropriate purposes and in accordance with the Agreements set forth in the application and award documents.

Leave This Blank:


33. 1. Receive an email copy of this form.
34. Email address

    This field is not part of the form submission.

35. Submit

* indicates a required field