Appendix 3
School-based After-school Learning and Support Programmes 2014/15 s.y.
Community -based Project – Final Report (up to 31/7/2015)
(This form, duly completed and signed, should be returned to the
Extended Support Programmes Section by mail or by fax on or before 30 September 2015)
Name of Organization
：
Project Title
：
Reference No.
：
Project Coordinator
：
Contact Person
Contact Tel. No.
A. Information on Activities under the Programme
Please provide information on all approved activities.
( I ) (a) Activities wholly held with collaborating school(s)：
No. of
participating
Name of activity
eligible
(List out all the
students in
approved activities) approved
activities #1
Extended Support
Programmes Section
Room 5203, 52/F,
Hopewell Centre,
183 Queen’s Road East,
Wanchai, Hong Kong
Fax No: 3107 1306
：
：
Actual no. of students served
Financial report
Eligible students
Non-eligible
students#2
Is the activity
Average
Average on schedule?
No. of
No. of
#3
students^ attendance students^ attendance
P S SP rate (%) P S SP rate (%)
Amount of
grant #4
Other
income#5
($)
($)
(B1)
(A1)
Subsidy
from
NGO
($)
(C1)
Expenses#6
($)
(D1)
Name of collaborating
school(s)
Remark
Total
Total no. of
activities:
__________
Total
Man-times
(total no. of
students listed
above):
__________
Total
Man-times
(total no. of
students listed
above):
__________
Average
rate:
_____%
Total
Man-times
(total no. of
students listed
above):
__________
Total($)
Average
rate:
_____%
^P – Primary School; S – Secondary School; SP – Special School
(A1)=
(B1)=
(C1)=
(D1) =
(Use separate sheets if necessary)
(b) Information of eligible students in collaborating schools (up to 31 July 2015)
Count by heads
Primary
No. of eligible students #1 benefitted:
(i)
Secondary
Special
Subtotal
School
：
Comprehensive Social Security Assistance (CSSA)
：
(ii) Student Finance Assistance Scheme (SFAS) full grant
(iii) total no. of disadvantaged students under the
discretionary quota (not exceeding 25%) (only
applicable to the students identified by the
collaborating school(s))
：
(iv) Total no. of eligible students benefitted : (i) + (ii)
=
+(iii)
(v) Total no. of non-eligible students (must pay full fee)： ：
=
Total no. of students: (iv) + (v)
( II ) (a) Activities wholly open to the community：
No. of
participating
Name of
activity eligible students
in approved
(List out
activities #7
all the
approved
activities) Od
Pv
Cs
Actual no. of students served
Eligible students #7
Financial report
Non-eligible students
#2
Primary
Od
Pv
Secondary
Cs
Od
Pv
Cs
Special
Od
Pv
Cs
No. of
Average
Average
students
attendance
attendance
rate (%) P S SP rate (%)
Amount
Is the
activity on of grant
#4
schedule?
($)
#3
(A2)
Other
income
#5
($)
(B2)
Subsidy
from
NGO
($) (C2)
Expenses #6
($)
(D2)
Total
Total no.
Total Man-times
of
Total Man-times
(total no. of
activities: students listed
(total no. of students listed above):
above):
_______
___
＿＿＿＿＿＿
＿＿＿＿＿＿
Average
rate:
_____%
Total
Man-times
(total no. of
students listed
above):
_____
Total ($)
Average
rate:
______%
(A2)= (B2)=
(C2)=
(D2)=
Remark
(b) Information of eligible students in open to the community activities (up to 31 July 2015)
Count by heads
Primary
No. of eligible students benefitted：
Od
Pv
Special
Secondary
Cs
Od
Pv
Cs
Subtotal
School
Od
Pv
Cs
(vi) Comprehensive Social Security Assistance (CSSA)
(vii) Student Finance Assistance Scheme (SFAS) full grant
(viii) total no. of disadvantaged students under the discretionary
quota #1(only applicable to the students identified by the
collaborating school(s))
(ix) Total no. of eligible students benefitted: (vi) + (vii) + (viii)
=
(x) Total no. of non-eligible students (must pay full fee)
:
Total no. of students (ix) + (x) =
(III)
Financial Summary of the whole project (up to 31 July 2015)
(E) administration cost
：$
(F) project coordination expenditure
：$
(G) administration cost and project co-ordination
expenditure subsidised by NGO
：$
(H) total project expenditure = (D1) + (D2) + (E) + (F)
= $
(I) amount of approved grant
：$
(i.e. the aggregate of three instalment payments claimed at your reply to EDB in
April 2015)
(J) interest earned (if any)
：$
(K) total project income = (B1) + (B2) + (C1) + (C2) + (G) + (I) + (J)
= $
balance = (K) – (H)
= $
Remarks：
#1. Eligible students: students in receipt of CSSA, SFAS full grant or disadvantaged students under the discretion quota (only applicable to the students provided by the collaborating school(s)).
#2. Non-eligible students: students who have to pay to participate. These students must pay full fee; full fee means the actual cost of an activity for each participating student (including eligible and
non-eligible students)（e.g. if the actual cost for the activity is $1,000 with a total of 6 eligible students and 4 non-eligible students participating in the activity, the cost for each participating student should
be $100; each not-eligible student should therefore pay $100）.
#3.
#4.
#5.
#6.
#7
Is the activity on schedule? The progress should be stated as: (a) completed or (b) cancelled.
Amount of grant: The amount allocated for the activity under the approved project, which should be used to subsidize only the eligible students, while non-eligible students must pay full fee.
Other income: other sources of revenue such as the fee paid by the non-eligible students, donation and sponsorship.
Expenses: the expenses for organizing the activity (including subsidy by NGO in the expense).
For activities also serving the whole community, priority should be given to eligible students from “Od” and “Pv” schools
- Od (students from Government, Aided or Direct Subsidized Scheme schools not listed in (I))；
- Pv (students from private schools)；
- Cs (students from collaborating schools listed in (I))
Name of *NGO/ Subsidiary
Centre or Unit of NGO
：
Name and Post of Head of
*NGO/ Subsidiary Centre or
Unit of NGO/ Project
： Name
Coordinator
Date :___________________
/ Post
Signature ：
(Head of *NGO / Subsidiary Centre or Unit of NGO/
Project Coordinator)
* (Delete whichever is not applicable)
Chop of *NGO / Subsidiary Centre
or Unit of NGO
Name of
Organisation：
Application
Ref. No. ：
B.
Project Effectiveness
In general, how would you rate the achievements of the activities conducted to the benefitted eligible
students:
Improved
Please put a “” against the most appropriate
Not
No
Declining
Significant
Moderate
Slight
Applicable
Change
box.
Learning Effectiveness
a)
b)
c)
d)
e)
Students’ motivation for learning
Students’ study skills
Students’ academic achievement
Students’ learning experience outside classroom
Your overall view on students’ learning
effectiveness
Personal and Social Development
f)
g)
h)
i)
j)
k)
l)
m)
Students’ self-esteem
Students’ self-management skills
Students’ social skills
Students’ interpersonal skills
Students’ cooperativeness skill with others
Students’ attitudes toward schooling
Students’ outlook on life
Your overall view on students’ personal and
social development
Community Involvement
n) Situation on students’ participation in
extracurricular and voluntary activities
o) Students’ sense of belonging
p) Students’ understanding on the community
q) Your overall view on students’ community
involvement
C.
Comments on the project conducted
Have you encountered any of the following problems / difficulties when implementing the project?
(You may tick more than one box)
□ insufficient manpower to conduct the activities;
□ collaborating schools unable to provide sufficient no. of eligible students (i.e., students receiving CSSA,
SFAS full grant);
□ eligible students unwilling to join the programmes;
□ cooperation with collaborating schools needs improvement;
□ unable to employ suitable tutors to conduct activities;
□ complicated to fulfill the requirements for handling funds disbursed by EDB;
□ the reporting requirements too complicated and time-consuming;
□ Other suggestions (Please specify):_____________________________________________
D.
Evaluation on the Project (use separate sheet if necessary)
1.
Have you conducted any survey to collect feedback on the activities under the Programme from the
collaborating schools, participating students, parents, teachers and staff involved on the project? If
yes, please attach the survey results.
If any other evaluation on the effectiveness on the project was also conducted, such as whether the
aims of the project can be achieved and the response of schools and parents to the project, please
state below.
2.
E(i) Activity Income & Expenditure Statement
School-based After-school Learning and Support Programmes 2014/15 s.y.
Activity Income & Expenditure Statement (up to 31/7/2015)
Name of NGO
:
Project Ref no.
:
Name of the Activity :
(Separate Statement for each approved activity)
(Please use separate sheet if space is not enough)
Actual no. of eligible students served:
Actual no. of non-eligible students served:
Income Items
HK$
Amount of grant approved for this activity
Fees collected from Non-eligible students
）
Others (Please specify:
Total Income (A)
Subsidy by NGO (B)
Expenditure Items
To be completed by collaborating school:
Total____groups, each group with____sessions x ____hr(s)
*and/or ____half day/full day Venue:__________________
Tutor fee (No. of tutors:
I confirm that the data in the box are accurate.
Name: _____________________
Post:*Principal/Teacher in charge
Signature: __________________ School chop
Date: ______________________
)
(No. of social workers:
)
(No. of other staff: _________)
Material expenses
Camp / Admission fee
Students’ meal
Activity transportation fee
Volunteers allowance (No. of volunteers:
Other (Please specify:
)
)
Total Expenditure (C)
Balance (A + B - C)
I have already checked all the information provided above and verified that all
expenditure receipts are certified true and correct. I also confirm that the above
approved activity is completed.
Name and Post of Head of *NGO/ Subsidiary Centre or Unit of NGO/ Project Coordinator:
Name:________________________________
Post:_____________________________________
Signature:
Remarks:
Date:
Chop of *NGO / Subsidiary Centre or Unit of NGO
*(Delete whichever is not applicable)
E(ii) Project Coordination Expenditure Statement
School-based After-school Learning and Support Programmes 2014/15 s.y.
Project Coordination Expenditure Statement (up to 31/7/2015)
Name of NGO
:
Project Ref no.
:
HK$
Approved Grant for Project Coordination (A)
Project Coordination Expenditure
Project coordination expenditure (Aug 2014)
Project coordination expenditure (Sep 2014)
Project coordination expenditure (Oct 2014)
Project coordination expenditure (Nov 2014)
Project coordination expenditure (Dec 2014)
Project coordination expenditure (Jan 2015)
Project coordination expenditure (Feb 2015)
Project coordination expenditure (Mar 2015)
Project coordination expenditure (Apr 2015)
Project coordination expenditure (May 2015)
Project coordination expenditure (Jun 2015)
Project coordination expenditure (Jul 2015)
Total Expenditure for Project Coordination (B)
Project Coordination Expenditure Subsidised by NGO (if any) (C)
Balance (D) = (A + C - B)
I have already checked all the information provided above and verified that all
expenditure receipts are certified true and correct.
Name and Post of Head of *NGO/ Subsidiary Centre or Unit of NGO/ Project Coordinator:
Name:________________________________
Post:_____________________________________
Signature:
Contact Tel. No.:
Remarks:
Date:
Chop of *NGO / Subsidiary Centre or Unit of NGO
*(Delete whichever is not applicable)
E(iii) Administration Expenditure Statement
School-based After-school Learning and Support Programmes 2014/15 s.y.
Administration Expenditure Statement (up to 31/7/2015)
Name of NGO
:
Project Ref no.
:
HK$
Approved Grant for Administration Expenditure (E)
Administration Expenditure Items
Staff transportation fees
Photo-copying
Stationery
Postage
Others (Please specify:
)
Total Expenditure for Administration (F)
Administration Expenditure Subsidised by NGO (if any) (G)
Balance (H) = (E + G - F)
I have already checked all the information provided above and verified that all
expenditure receipts are certified true and correct.
Name and Post of Head of *NGO/ Subsidiary Centre or Unit of NGO/ Project Coordinator:
Name:________________________________
Post:_____________________________________
Signature:
Contact Tel. No.:
Remarks:
Date:
Chop of *NGO / Subsidiary Centre or Unit of NGO
*(Delete whichever is not applicable)