Please Do Not Email the Word Template in Lieu of the Survey

Thank you for submitting your Marisla Final Report.

This is the Word version of the survey submission questions. We recommend that you prepare your responses in advance on this word template, save it and then copy and paste your answers into the online submission form. Please keep a copy of the completed word template for your records.

Please do not email the Word template in lieu of the survey.

Please submit at this link: https://www.surveymonkey.com/r/MarislaReport2017

A thank you message will appear at the end of the report to show that the report has been submitted.

For questions, please contact .

Grantee Information

*indicates a required question

* 1. Organization name

* 2. Project (if applicable)

* 3. Amount Granted for Reporting Period

* 4. Month/Year Received

* 5. Primary contact name

* 6. Contact Email

* 7. Contact Phone

* 8. What program area did you apply under?

ð Environment

ð Human Services

ð Special Interests

Environment

*9. Summary of accomplishments (100 word limit) Include measurable indicators, if possible.

* 10. Description of progress toward outcomes described in your application (500 word limit) Defined as impacts or changes that will be achieved in 1-5 year as a result of your (and partners’) efforts. These may include a policy, human behavior or activity, or state of ecosystem or species.

* 11. Description of outputs achieved (200 word limit) Defined as the direct results of short-term (1-2 year) activities undertaken with the Marisla Foundation grant. Bulleted lists are acceptable; please include quantitative criteria where appropriate.

* 12. Indicators of progress toward stated outcomes (100 word limit) Defined as quantitative or qualitative measures toward achieving an outcome (e.g., increased biodiversity, increased species, decrease in illegal activity, area protected, reduction of exposure to toxins, etc.).

* 13. Please share any stories of success that you are most proud of.

*14. Description of potential challenges (internal or external) that your organization may encounter when implementing this project/program and potential strategies for overcoming them (100 word limit).

Financial Report Summary

The budget section will follow the template below. It is recommended to draft your responses using this format and then input each line item into the SurveyMonkey. Please report on your entire program budget. Only numerical data is allowed. Do not include periods or dollar signs. Put "0" and not "N/A".

15 and 16 covers your proposed Budget and Actual Expenditures

15. Budget

Salaries and Benefits
Consultants and Subcontractors
Travel
Conferences and Meetings
Rent
Office Equipment
Office Supplies, Postage, Telephone, Website
Communications
Indirect Costs (not to exceed 15%)
Other
Total Budgeted Expenses

16. Actual Expenditure

Income Sources

17. Funding Source and Amount Stated in Proposal (E.g. Income Source Number #1: ABC Foundation, 20000)

Income Source #1
Income Source #2
Income Source #3
Income Source #4
Income Source #5
Income Source #6
Income Source #7
Income Source #8
Income Source #9
Income Source #10
Total Income State in Proposal

18. Actual Funding Source and Amount (E.g.Income Source Number #1: ABC Foundation, 10000)

19. Budget Report Narrative: Please provide text to supplement information provided in budget matrix. Specifically, if there are any variances please describe and share the reasoning. If the actual income differs from the stated, please describe why and how you adjusted your activities to accommodate this change.