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Outcome Report
REPORTING REQUIREMENTS
Organization's formal name
CEO's Name
Address
City
State
Zip
Contact phone number
Contact name
Person completing this outcome form
Contact email address
Date funds were received
1.) Funded Program
Amount funded
Area(s) of focus for this program:
Choose 1-2 only.
Racial Social Justice
Immigrants & Outreach
Low-Moderate Income
Veteran Services
Individuals with Disabilities
Gender Equity
Youth Services
Food Insecurity & Hunger
Social Economic
Climate Change/Environment
Elder Services
Education
Economic Development
Arts & Culture
Health & Human Services
Mental Health
Number of people served/attended for each area of focus chosen
(ex: if you chose 2 areas of focus you must give the number of people for each focus)
2.) Funded Program
Amount funded
Area(s) of focus for this program:
Choose 1-2 only.
Racial Social Justice
Immigrants & Outreach
Low-Moderate Income
Veteran Services
Individuals with Disabilities
Gender Equity
Youth Services
Food Insecurity & Hunger
Social Economic
Climate Change/Environment
Elder Services
Education
Economic Development
Arts & Culture
Health & Human Services
Mental Health
Number of people served/attended for each area of focus chosen
(ex: if you chose 2 areas of focus you must give the number of people for each focus)
3.) Funded program
Amount funded
Area(s) of focus for this program:
Choose 1-2 only.
Racial Social Justice
Immigrants & Outreach
Low-Moderate Income
Veteran Services
Individuals with Disabilities
Gender Equity
Youth Services
Food Insecurity & Hunger
Social Economic
Climate Change/Environment
Elder Services
Education
Economic Development
Arts & Culture
Health & Human Services
Mental Health
Number of people served/attended for each area of focus chosen
(ex: if you chose 2 areas of focus you must give the number of people for each focus)
Demonstration of program/event execution
(e.g. media coverage, advertising, photographs)
PLEASE NOTE:
Do not attach excel spreadsheets here. Please send separately to areese@greylock.org
Max. of 4 attachments allowed. Send additional attachments to areese@greylock.org.
Select File(s) to Upload
FOR REQUESTS OVER $1,000:
All requirements of previous level; plus
How long has Greylock been a supporter of this program/event?
Have you seen an increase in the number of participants this year?
Yes
No
N/A
If yes, what is driving the increased need?
Did this program/event achieve its desired outcomes or goals stated from the Sponsorship Request?
Please explain.
What are your key performance indicators for the program?
If you can't quantify, please explain.
Will this program/event continue or be repeated?
How did you recognize Greylock's contribution?
Narrative demonstrating how Greylock's involvement contributed to the success of the program/event
(Impact stories)
Have you seen an upward trend in need?
How many sponsors/funders participated in the event?
Please share what progress you have made with your inclusion efforts.
Share a brief story here.
Please share what challenges your have faced. What did you learn? What resources would help with those?
What changes will you plan to implement the next time this program is executed?
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