Contact information Organization name Project name Executive Director/CEO Name Name of person completing this report First Last Email of person completing this report Report narrative Describe any deviance from proposed activities to actual activities. For progress reports only: Are you currently on track with the timeline proposed in your application? If not. please explain. Participant Demographics For each demographic category, enter the number of participants. Do not leave any fields blank. Enter 0 when appropriate. Declined to share = You made an attempt to collect this information and the participant actively chose not to respond. Unknown = You could not collect this information. If you have unknown demographic data, include an explanation in the "Additional participant demographic information" box at the end of the demographic section. Briefly describe who is included in the group of participants whose demographics are reported below. More Clarify who is included...is it youth who attended at least two hours of programming? Community members who attended an in-person event? People who called for information and were connected to a case worker? Etc. Total unduplicated number of participants to date Each demographic category below should total to match this number. Participant Zip Code 53108 53126 53177 53402 53403 53404 53405 53406 53105 53139 53167 53182 53185 Declined to share zip code Unknown zip code Zip code(s) not listed and number of participant(s) from each The total number entered in this section should match the total unduplicated number of participants to date. Participant age 0-5 years old 6-17 years old 18-44 years old 45-64 years old 65+ Declined to share age Unknown age The total number entered in this section should match the total unduplicated number of participants to date. Participant race African American/Black American Indian and Alaskan Native Asian Native Hawaiian and other Pacific Islander White Two or more races Other race not listed Declined to share race Unknown race Describe the race of participants identified as "other race not listed". The total number entered in this section should match the total unduplicated number of participants to date. Participant ethnicity Hispanic or Latino Not Hispanic or Latino Other ethnicity not listed Declined to share ethnicity Unknown ethnicity Describe the ethnicity of participants identified as "other ethnicity not listed". The total number entered in this section should match the total unduplicated number of participants to date. Participant gender Male Female Transgender Nonbinary Declined to share gender Unknown gender Other gender not listed Describe the gender of participants identified as "other gender not listed". The total number entered in this section should match the total unduplicated number of participants to date. Clarify any data provided above and/or share additional participant demographic information (optional). Participant economic status Use the following information to determine participant economic status. Income levels are based on the 2024 Poverty Guidelines for the 48 Contiguous States and the District of Columbia, Federal Register document 87 FR 3315. HOUSEHOLD ANNUAL INCOME Extremely low-income Very low-income Low-income Other Household Size: Less than 100% of poverty Less than 185% of poverty (Qualifies for Free and Reduced-Price Lunch (FRPL)) Less than 250% of poverty Over 250% of poverty 1 $15,060.00 $15,060-$27,861 $27,861-$37,650 $37,650 + 2 $20,440.00 $20,440-$37,814 $37,814-$51,100 $51,650 + 3 $25,820.00 $25,820-$47,767 $47,767-$64,550 $64,550 + 4 $31,200.00 $31,200-$57,720 $57,720-$78,000 $78,000 + 5 $36,350.00 $36,350-$67,673 $67,673-$91,450 $91,450 + 6 $41,960.00 $41,960-$77,626 $77.626-$104,900 $104,900 + 7 $47,340.00 $47,340-$87,579 $87,579-$118,350 $118,350 + 8 $52,720.00 $52,720-$97,532 $97,532-$131,800 $131,800 + Extremely low-income Very low-income Low-income Other Declined to share income Unknown income The total number entered in this section should match the total unduplicated number of participants to date. Project-specific Data Describe the direct impact the funding had on the individuals served by this project/program. Describe any indirect impact the funding had on your clients/participants and/or community. What was your identified focus area for your project/program? Increase in job-readiness skills. Increase in earning potential through increased knowledge/skills that facilitate access to jobs with higher wages. Increase in educational attainment (pre-Kindgergarten and K-12) Increase in access to and utilization of physical and/or mental health services Increase in job readiness skills (choose 4). Enter the number of participants who achieved each indicator. Time Management Work ethic Problem solving Critical thinking Leadership Personal development Professionalism Decision making Emotional intelligence Communication Increase in earning potential through increased knowledge/skills that facilitate access to jobs with higher wages (choose 1). Enter the number of participants who achieved that indicator. Certification completion Credential completion Industry-specific upskilling via hands-on experience Industry-specific upskilling through course completion Increase in educational attainment (pre-Kindergarten and K-12) (choose 1). Enter the number of participants who achieved that indicator. Enter the number of participants who achieved that indicator. Reading/writing/literacy skills Math/numeracy skills Gross or fine motor skills Critical thinking Information, media and technology skills STEAM skills Increase in access to and utilization of physical and/or mental health services (choose 1). Enter the number of participants who achieved that indicator. Acute care Chronic disease management Medication Management Physical and/or occupational therapy Behavior health therapy Cognitive therapy Support groups Describe how you measured each indicator. Provide 2-3 sentence statement of impact that can be used as a stand-alone quote. Include the name and title of the person quoted. Provide links to any social media posts,medial releases, marketing collateral, etc. related to the project/program/event/funded. Is there any additional information you would like to report? I will attach photos that demonstrate program impact to an email reply to the confirmation email upon submission of this report. ONLY FOR FINAL REPORTS: I will attach a financial report that documents grant fund expenditures to an email reply to the confirmation email upon submission of the final report. Data entered should be unduplicated to date. Leave this field blank
