Final Evaluation with table

  1. This form is not to be used to request a new application.

  2. Koch Foundation requires an evaluation of all funded programs within one year of receiving a grant. If funds are not spent within one year, then a progress report must be provided every six months until such time as funds are expended.
  3. Grant Application Number(*)
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  4. Enter E-mail if you wish to recieve a copy of your submission
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  5. Organization (Grantee)(*)
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  6. Postal Mailing Address(*)
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  7. City/District, State/Province, Country, Zip/Postal Code(*)
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  8. The following pages contain questions that must be completed. Please submit this form supplying the required information. Limit your answers to the space provided.
  9. From my own knowledge, I state that the information given is complete and correct.

    Name of Person Administering the Grant
  10.  
  1. A. Results of Grantee’s Program:
  2. 1. How many people were served?(*)
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  3. 2. What was the time and place of principal activities?(*)
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  4. 3. How were the evangelization objectives met? (Please provide a description.)(*)
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  5.  
  1. 4. How will the program continue after Koch Foundation funding?(*)
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  2. B. Income and Expenditure Report: (Please provide a detailed account of how the grant money was spent; list all income that was contributed to this project and all expenses to date).(*)
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  3. Addendum to the expenditure report

    Please articulate the line items for any figures in the above expense report. If a field is not relevant to your project you may leave it blank. All dollar figures must be in whole United States Dollar (USD) amounts or your submission can not be accepted and your file will not be closed.
    Amount Recieved from the Koch Foundation Inc. $
    (-)Salaries & Benefits $
    (-)Travel & Lodging $
    (-)Printing & Postage $
    (-)Supplies including Food $
    (-)Equipment $
    (-)Construction* $
    (-)Other $
    Total (This will automatically update) $
  4. * Please key in any detailed bill of sales you may have, or itemized list into (4B.) above.
  5. Notice to Grantees: If you are interested in sending an attachment with your report, please send a separate e-mail with the attached documents or files to: staff@thekochfoundation.org. Thank you
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