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 firstname.lastname@example.org 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).