Community Climate Grant Reporting Form

Name of Organization

Name of Project Contact Person

First

Last

Email:

Phone:

Project Information

Name of Project:

Grant Amount Received (from Lanark County Community Climate Grant):

Completion Date:

Impact and Overall Result of the Project

Provide as much detail as possible; numbers; anything that will illuminate the value of the project to the people of Lanark County. Discuss how it provides a climate or environmental benefit to Lanark County. Any quotes or stakeholder/user impacts (if applicable) are excellent.

Final Project Budget

Please provide full budget details below, including a list and description of revenue, expenses and the net surplus/deficit. You may alternatively upload a spreadsheet/document outlining the budget. We may request invoices.

signature) to of

Additional Documents and Authorization

Please upload supporting material (i.e. evaluation report, invoices, etc.)

Drag & Drop Files, Choose Files to Upload You can upload up to 5 files.

Allowable file types are .doc, .pdf, .docx, .rtf.

Please confirm the following information

I confirm that the information provided is truthful and complete.

Signature (typed name to constitute signature)

How Lanark County Governs

Supporting Jobs, Business & Growth

Caring for Our Community

Project Information

Impact and Overall Result of the Project

Final Project Budget

Additional Documents and Authorization

Government

How Lanark County Governs