Company name

Cobb EMC Foundation
Yearly Initiative Reporting 

Receiving a grant from the Cobb EMC Foundation is only a part of your relationship with us as a grantee. In order to understand your impact through our investment, build our knowledge of community issues and communicate back to our members we require each grantee to report back their progress and impact in the community. Please make sure to submit this signed and dated post grant form to be considered for future funding requests.  

1. Name of Organization: **
2. Address: **
City: **		State: * Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho IllinoisIndiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri MontanaNebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon PennsylvaniaRhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming	Zip Code: **
3. Contact **		Email Address: ***
4. Phone Number: **
5. Actual number served by this specific Cobb EMC–funded contribution: ***
6. Provide overview of project, include significant achievements and milestones. Were there any challenges or issues? Based on the Grant Application form submitted with our proposal, describe the results of the project: **
7. List key metrics used to measure success and a summary of the project financial status. **
8. Upcoming activities and adjustments (reports, pictures, flyers). *
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Signature Date: **	Signature **

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