Mini Grant Final Report Form - Chesapeake Crossroads Heritage Area

Comments

This field is for validation purposes and should be left unchanged.

Grantees MUST EMAIL GRANTS@CHESAPEAKECROSSROADS.ORG to notify us that you are ready to close your grant. ~ WE RECOMMEND that you copy this page and prepare your answers in a Word document ahead of time, then return to the form to cut and paste in your responses and upload supporting materials. Submit everything all at once. IMPORTANT: When you submit your final report, you will see a confirmation page on your computer. You will also get an emailed copy of this form once your submission has been successfully delivered.

GRANTEE & PROJECT INFORMATION

Legal Name of Applicant Organization as shown on the grant agreement*

Project Contact Name and Title*

Title First Last

Organizational Email*

Enter Email Confirm Email

Date of Executed Agreement*

This award was made during*

FY26

FY27

Did you complete the project within the scope and budget that was approved in the executed grant agreement?*

YES: Proceed to Project Outcomes & Results Section

No: Contact the CCHA Office to discuss the changes and whether a grant amendment is needed.

PROJECT OUTCOMES & RESULTS

Brief Description of the Grant Outcomes*

List Primary Deliverables/ Products

Deliverable/ Product #1*

Deliverable/ Product #2

Deliverable/ Product #3

How did you measure success and/or track the results and impact of your project?*

What audiences did you reach with the project?*

Provide numbers of participants/ visitors, and if available, demographic profiles of your audience(s)?

Did your project recognize the CCHA and MHAA as per the terms of the grant agreement?

Please include proof in the attachments below or in the narrative

Yes

Collaboration or Partners

If your project included a collaboration with CCHA partners, describe how that partnership impacted the project outcomes

If you have digital links related to your project, (websites or youtube videos for example) share them here

Enter URLs one per field

AND / OR

Upload Digital copies of your deliverables / products/ images below*

If you have multiple documents, please combine them into one file to upload here. Total size of all files for this section not to exceed 5 MB
If the product exceeds this file size, please contact grants@chesapeakecrossroads.org for alternative delivery options.

Drop files here or

Accepted file types: pdf, doc, jpg, jpeg, docx, png, xls, xlsx, csv, Max. file size: 5 MB.

Consistency and Relevance with Management/ Strategic Plans

Please select how your project or event highlighted the following CCHA interpretive themes

Applicable Themes*

Crossroads of Place

Crossroads of Culture

Crossroads of Struggle for Equality and Freedom

Crossroads of Social Change

Check all that apply

Did this project or event directly support goals found in the NEW Six-Year Action Plan FY27-FY32.

Applicable Goals*

Tourism Impact – Attracting visitors, encouraging heritage tourism, and increasing awareness of the region

Community Engagement – Building meaningful connections through partnerships, education, volunteerism, and public participation

Sustainability – Creating lasting benefits through preservation, stewardship, organizational capacity, or long-term community impact

Check all that apply

Briefly describe in what ways the project highlighted the CCHA Interpretive themes and how it supported the three core goals of the Six year action plan?*

Please provide a comment or feedback on how this grant funding impacted your organization's ability to do its work?*

Anything else you would like to share about your project, or would you like to provide feedback on the grants process?*

FINANCIAL REPORT & REQUEST FOR DISBURSEMENT

A) CCHA Grant Funds Expended*

B1) Total CASH Match Applied*

B2) Total IN KIND Match Applied*

C) Total Project Cost

A + B1 + B2 = C

Does this financial accounting differ from the approved budget (amounts or line items) in your executed grant agreement?*

Yes

If YES, explain any deviations here*

GRANT DISBURSEMENT AMOUNT REQUESTED

Documentation of Expenditures & Match*

Provide proof of ALL cash expenditures (both grant award funds and any cash match attributed to the project): (* Note: remember that matching funds CANNOT come from State sources.) Acceptable documentation for proof of cash expenditures includes invoices, receipts, timesheets, contracts, payroll and/or accounting system reports (e.g. QuickBooks). These records should show what was purchased or completed, when it occurred, and the cost.
Combine as much as possible into a single file and Upload those files here. Total size of all files for this section not to exceed 5 MB

Drop files here or

Accepted file types: pdf, doc, jpg, jpeg, docx, png, xls, xlsx, csv, Max. file size: 5 MB.

If you are applying IN KIND match to your Total Project Cost, please provide a description and briefly explain how that match was achieved here:

If you have used volunteer time to meet your in kind match, please include a written log of their hours, dates of service and a brief description of the volunteers contributions: (A template is provided below, but if you have documentation in another file format, that may be uploaded here instead/)

Download the CCHA Volunteer Log Template

Upload those files here. Total size of all files for this section not to exceed 5 MB

Drop files here or

Accepted file types: pdf, doc, jpg, jpeg, docx, png, xls, xlsx, csv, Max. file size: 5 MB.

CONSENT & CERTIFICATION

In signing this report, I hereby agree that this application is being submitted with electronic signatures and shall be valid and binding.*

By checking this box, I certify that the information contained in this report is true, accurate, and correct, and I am legally authorized by the applicant organization to submit this report on their behalf.

Grantee's Signature*

Date*

Print Grantee’s Official Representatives Name*

First Last

Title*

CCHA Mini Grant Final Report & Disbursement Request

GRANTEE & PROJECT INFORMATION

PROJECT OUTCOMES & RESULTS

List Primary Deliverables/ Products

AND / OR

Consistency and Relevance with Management/ Strategic Plans

FINANCIAL REPORT & REQUEST FOR DISBURSEMENT

Download the CCHA Volunteer Log Template

CONSENT & CERTIFICATION

Helpful Links

Need the CCHA or MHAA Logos?

Does your project include an Interpretive Sign?

Grant-Writing 101

Grant-Writing 201

Print Newsletter

E-Newsletter