Operating Location Name

Project Funding Code

Name of individual completing this form

First Name

Last Name

Email Address

Quarterly Reporting Period

Year

For the following questions, please enter all $ amounts in CAD - Canadian Dollars

IF APPLICABLE, list the total amount of donations that remained unspent in the previous Quarterly Reporting Period

List the total amount of donations received from Project Funding within the designated Quarterly Reporting Period

Out of the total amount above, enter how much was spent within the designated Quarterly Reporting Period

Of the total amount received, enter how much was NOT spent within the designated Quarterly Reporting Period

Use of Funds

Describe (Impact & Outcomes) how the distributed donation funds were used within this Quarterly Period, in as much detail as possible