POST-GRANT EVALUATION FORM FINAL PROGRAM REPORT All organizations that have received a grant from the Field Foundation are required to submit this final program report within 30 days of the grant’s one-year expiration. If necessary, you may attach up to three additional pages. Organization: Contact Person Phone Number: Grant Type: e.g., Project Support, Capital Support or Operating Grant Period Ending: e.g., If a grant was awarded in the spring of 2011, the grant period ending would be spring 2012. Grant Amount: Field Foundation Program Officer Contact: The Field Foundation uses this report to better understand organizations’ experiences and to inform our grant making at an aggregate level in various priority areas. We hope to learn with you and from you, recognizing that projects often turn out differently than planned. Please keep in mind that the Field Foundation reviews proposals on a case by case basis and does not necessarily penalize organizations when less progress is made than was anticipated. Rather, the Foundation believes that as much can be learned from challenges as successes, and appreciates organizations that adjust their programming when necessary. The Foundation hopes that you will see this report as an opportunity to reflect upon your work this past year. Feel free to call a Field Foundation program officer if you have any questions. 1. Please describe any significant accomplishments, success stories, knowledge gained and/or lessons learned. 2. Please briefly summarize any quantitative and qualitative goals and objectives outlined in your original proposal. 3. Please report specific quantitative and qualitative results of each of the above-stated goals and objectives (e.g., number of persons served, demographics). If available, please include any relevant evaluation outcome data. 4. Please describe any significant contextual factors that may have impacted your ability (positively or negatively) to implement the funded project or your broader work (e.g., challenges or opportunities, such as funding issues or collaborative partnerships). 5. Please describe one or two ways your agency impacts broader community issues. 6. How were the Field Foundation’s funds specifically used (e.g., staff salaries, professional development, materials, consulting)? a. What is the amount of the program/project budget towards which the Field Foundation grant was applied: $___________________ b. What percentage of the above budget was funded by the Field Foundation? _______% c. Where applicable, how was the remainder of the budget funded? 7. Will the funded activities be continued? Yes No Unsure (if unsure, please explain) 8. Do you have feedback on how the Field Foundation might be more helpful to organizations it funds (e.g., application process, review process, level of funding)? Thank you for your responses. Please mail this completed form to the Field Foundation 200 S. Wacker Dr. Ste. 3860, Chicago, IL 60606