Title III Quarterly Report

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Title III Quarterly Report
Due January 15, April 15, July 15
Please note that you can type of this form
Completed forms should be emailed to [email protected]
Name of activity _________________________________________________________________________________________
Activity director__________________________________________ Report period____________________________________
1.
List each objective and provide a brief summary of what you have accomplished during the past 3 months. Include
quantitative measures of progress and baseline data for each objective (add as needed).

Objective 1

Objective 2

Objective 3
2.
For each objective indicate the level of accomplishment by percentage as of the end of the quarter.

Objective ___________
Percentage of completion ____________%

Objective ___________
Percentage of completion ____________%

Objective ___________
Percentage of completion ____________%
Please make any notations you deem necessary to explain the above.
When do you anticipate the overall completion of each objective?

Objective 1

Objective 2

Objective 3
3.
What evidence is being collected to document achievement of each identified objective (explain and attach).
4.
Indicate any problems you are having in accomplishing your stated objective(s).
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