This form must be completed within 30 days of event or receipt of funding award 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering your organization’s name in the designated field. This ensures that your submission is properly attributed.
3. Next, provide the name of the event for which you are reporting. This helps contextualize your funding request.
4. Indicate how many people participated in the event. Accurate numbers are crucial for evaluating community impact.
5. Fill in the percentage of net proceeds that remain in the local community. This information is vital for assessing future support.
6. Detail how many persons were served during the event. This metric reflects the outreach and effectiveness of your initiative.
7. In the provided space, explain how this event benefited the community. Be thorough and specific to highlight its impact.
8. Once completed, review all entries for accuracy before submitting it to Angela Hayes at Summa Health System using the provided contact details.

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