Let’s Talk About It
Project Director’s
Concluding Reports
Thank you for hosting a Let’s Talk About It program! Please complete this seven (7) page Concluding Reports
packet. This information is necessary for our federal reporting, capturing the impact of our programs and designing
future programs.
Prepare these reports at the conclusion of your program and send it via email to cpatton@nchumanities.org or first-class
mail to Caitlin Patton at:
North Carolina Humanities Council
320 East 9th Street, Suite 414
Charlotte, NC 28202
Phone: (704) 687-1520
Fax: (704) 687-1550
Section 1: Project Information
Series Title:
Grant #:
Project Director Name:
Sponsoring Organization:
Project Director Address:
Phone:
City:
State:
Zip:
Final Report Due Date:
Email:
Grant Award Amount:
Grant Match Total (In-Kind and Cash Contribution):
Program Location:
City:
NC Senate District:
NC House District:
County:
US Congressional District:
What is your overall impression of the Let’s Talk About It discussion session?
Page 1 of 7
Let’s Talk About It
Project Director’s
Concluding Reports
Section 2: Reporting In-Kind and Grant Matching
This section documents the Grant Match and captures the Cash and In-Kind contributions of your organization toward the
hosting of this event. Please complete the “Local Matching In-Kind/Cash” column using the instructions provided below.
Instructions for Use and Preparation
1.
The amounts in the “Humanities Council Funds Expended” column should reflect Humanities Council funds actually
used in carrying out the project. The amounts therefore may be less than those appearing on your grant award.
2.
The “Local Matching In-Kind/Cash” column is for showing contributions of cash and of in-kind or donated services,
facilities, etc. (Grantee is advised to check the proposed match set forth in the project proposal to the Humanities
Council.) Each code line need not be matched. The Humanities Council’s requirement is that the total local match––
however distributed–– a 1-to-1, preferably 2-1, match of the total Humanities Council funds used in your project.
Please consult the table below for examples.
Administrative time
Supplies and Equipment
Rental
Travel, Meals, Lodging
Rental of Facilities
Printing and Publicity
Other (please itemize)
Donated time of project director, Treasurer or Financial Officer , planning
committee, consultant, etc. (if hourly rate is unknown use $15.00)
Fair market rental value of video or other equipment provided, postage &
paper, cost of refreshments served at programs, etc.
Mileage at $.575 per mile and any out-of-pocket meals or lodging while
traveling on behalf of the project.
Fair market rental value of meeting/event space your organization provided.
Value of promotion time/space donated by television stations or
newspapers, use of photocopier, etc.
Contributions not fitting categories above.
Please specify the nature of these contributions.
3.
Add all columns vertically and horizontally. Indicate at the bottom of the form how much of the local matching is inkind contributions and how much is cash.
4.
This report must be signed by the Project Director and the Treasurer or Financial Officer.
Page 2 of 7
Let’s Talk About It
Project Director’s
Concluding Reports
Section 2: Reporting In-Kind and Grant Matching Cont.
Reporting In-Kind and Grant Matching
a.
Item Code
Administrative/volunteer
time spent in preparation
I
North Carolina Humanities
Council
Funds Expended
II
Local
Matching
Cash
III
Local
Matching InKind
IV
TOTAL
------
b.
Employer’s Retirement
------
c.
Employer’s FICA
------
d.
Scholar Stipends
e.
Supplies and Equipment
Rental
------
f.
Travel, Meals, Lodging
------
g.
Rental of Facilities
------
h.
Printing and Publicity
------
i.
Other (please itemize)
--------------------TOTAL
$
Total Local Match (Column II + III)
Project Director Signature (please do not type):
Title:
Date:
Treasurer or Financial Officer Signature (please do not type):
Title:
Date:
Page 3 of 7
Let’s Talk About It
Project Director’s
Concluding Reports
Section 3: Program Participation and Statistics
Let’s Talk About It Program Statistics
Session 1
Session 2
Session 3
Session 4
Session 5
Session 6
Title of Book
(or Film)
Date
# of
Participants
Name of
Scholar
Scholar’s
Affiliation
Program Participation
Total Number of Participants
Racial/Ethnic Background
Population Distribution
Age
# Urban
# Children
# African-American
# Rural
# Adult
# Asian-American
Educational Background
# Retired
# Latino
# Limited
# Native American
# High School
# Caucasian
# College
# Male
# Group not listed
# Post-Graduate
# Female
General comments about audience participation:
How did you promote and publicize your project?
Page 4 of 7
Gender
Let’s Talk About It
Project Director’s
Concluding Reports
Section 4: Project Director’s Evaluation of the Scholar
Please complete this page for each Scholar that your site hosted as a part of the program and submit all
evaluations together with the final report. You are welcome to attach additional pages to respond to the
following questions.
Series Title:
Today’s Date:
Project Sponsor:
Grant #:
Project Director’s Name:
Name of Scholar:
Book/Topic Discussed:
1.
Did the scholar speak to the topic for which you engaged him/her? If no, please explain.
2.
How do you rank this scholar’s presentation quality?
3.
Please describe any unique, imaginative, or interesting aspect of the scholar’s presentation:
4.
Was the scholar’s delivery appropriate for your audience?
5.
Please explain:
Was the scholar able to present a complex idea, subject or issue?
6.
Please explain:
What was the most significant contribution made by the scholar?
7.
Was the speaker able to develop the topic well enough to draw the audience into a discussion so that the
different viewpoints could emerge?
Please give examples of the variety of the views represented in the group:
8.
How would you describe the quality of the discussion between the scholar and the audience?
9.
Would you recommend this scholar again? Why or why not? Please add any additional comments.
Page 5 of 7
Let’s Talk About It
Project Director’s
Concluding Reports
Section Five: Financial Journal
Instructions for Use and Preparation *this section of the report should be completed by the
project’s Treasurer or Financial Officer*
1. Enter in column 2 the check number or, when and where appropriate, the journal entry
number. For credit card purchase, use the check number used to pay the credit card company
for the expenses.
2. Enter in column 4 the item code letter for which the expenditure is being claimed. (You will
note that in column 1 of the Expenditure Report, each code item is preceded by an identifying
letter. For example, "a" is the code letter for salaries; "d" is for stipends for scholars, etc.)
If you made allowance in your budget to pay scholars’ travel expenses in addition to stipends,
please show these amounts separately on this form. If one check was issued to cover both,
simply designate the portion that went to stipends (Code D) and the portion that went to travel
(Code F). Do not combine D/F.
Please prepare the Finical Journal table on the next page to support and accompany
the Expenditure Report when filing for reimbursement or reporting expenditures from a
cash request. Please append additional pages if needed.
Sponsoring Organization
Report Date
Grant Number
Total Number of Pages in the Financial Journal
pages
Page 6 of 7
Let’s Talk About It
Project Director’s
Concluding Reports
Section Five: Financial Journal Cont.
1
Check Date
2
Check # or
Journal
Entry #
Financial Journal Table
3
Payee
4
5
Item Code
Amount
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
TOTAL THIS PAGE
Page 7 of 7