Individual Project Summary
District Simplified Grant #_______________
Note: Rotarians completing an individual project summary should return this form to their District Leadership or to the District Simplified Grant Committee established at the district level._________________________________
1. Project Title: ___________________________ 2. Rotary Club: ________________________________
3. Report Type: Progress Report
Provide an itemized statement detailing how grant funds have been expended to date.
Final Report
Provide an itemized statement detailing how grant funds were expended on this pro-
ject from its implementation through completion.
Community Impact_____________________________________________________________________
4. Provide detailed information regarding the project and its beneficiaries. How many non-Rotarians benefited from this project? ______________ How were they helped?
5. How has the project provided community members with specific skills or knowledge that will allow them to help themselves?
6. If a cooperating organization was involved, what was its role?
Rotarian Involvement____________________________________________________________
7. How many Rotarians participated in the project? _______________ 8. How did they participate?
9. Provide an overview of project spending below (retain receipts of all expenditures):
Items purchased/Project expenses Cost (in local currency)
________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Total funds expended in local currency____________________________
10. By signing this report, I confirm that District Simplified Grant funds __________ (local currency) were spent in accordance with Trustee approved guidelines and that all of the information contained herein is true and accurate. Receipts for all expenses will be retained for at least three years in case of audit.
________________________________________________________________________________
11. Certifying Signature Date
________________________________________________________________________________
12. Please print name, Rotary Title and club
