Covenant Partner
Annual Activity Report 2016
(Fiscal year July 1, 2015-June 30, 2016)
Please return to Brenda Barton via email at or fax to 850-254-1926 by July 28, 2016
General Information
Date Submitted: ______
Submitted by:______
Name of Covenant Partner:
______
Office-and/or official mailing address-please list both street and PO Box address
(We need a street address when shipping packages)
Main contact person:______
Official MailingAddress:______
Physical Address for shipping ______
City______State______Zip______
Phone: ______Fax: ______Cell: ______
Email: ______Website: ______
Communication Tools:Please mark if you have the following
Newsletter: Mailed ______monthly_____ quarterly____other______
eNewsletter______monthly_____ quarterly____other______
Social Media Tools: Please share with us if you use any of the following along with the URL
Facebook______Twitter______YouTube______
Blogging______Others______
Demographics and Project Counts
Previous Totals Since Becoming a Fuller Center / Totals For This Fiscal Year (7/1/2015-6/30/2016) / Totals For Our Covenant Partner to Date / Projections for 2016-2017 Fiscal YearDESCRIPTION OF PROJECTS
New Homes - completed
New Homes - in progress
Major Rehabilitation “ReNew” Projects - completed (Cost is more than $5,000)
Major Rehabilitation Projects - in progress
# Foreclosed Properties Received
Greater Blessing Projects- completed (Cost is less than $5,000)
# of Homeowners on Mortgages
# of homeowners WITH LOAN/MORTGAGE making payments considered current
Do you service your own mortgages-please mark yes or no in boxes
# of FCH homeowners in foreclosure or facing other legal action due to non-payment to FCH
# of Greater Blessing project homeowners making payments (No loan-agreement only)
DESCRIPTION OF PROGRAMS
Approximate # of volunteers
Approximate # of volunteer hours
# of local Student Builder partner organizations
# of Church/Faith partnerships
# of RV Builders hosted
# of US Build Teams hosted
# of times hosted Bike Adventure
# of Special/Community Projects/No FCH application/criteria/or repaymentused for these projects)
The number of projects listed above should equal the total number of families in the first box below / A / B / C / D / E / F / G / H / I
Total Families served for current fiscal year 7/1/2015-6/30/2016 * / This box/column should equal total number of individuals in boxes A, B, C, D, and E / White / Black/African American / Hispanic / Asian/Pacific Islander / Other and Multi-Racial / This box/column should equal total number of individuals in boxes F, G, H, and I / # Seniors in Household (65+) / # Children in household <21 / # Handicap or special needs / # of Veterans
*Please note that the number of families (not individuals) should equal the number of all projects listed for the fiscal year on page 2 of annual activity report.
Basic Financials:
(Financials based on fiscal year beginning July 1, 2015 through June 30, 2016)
Revenue:
Funds Raised:
Undesignated: ______
Designated: ______
Grants Received:
Total amount of awards:______
Revenue from ReUse Store:______
TOTAL REVENUE: ______
(All annual activity reports must include a Profit and Loss Report and a Balance Sheet if you are not able to provide at time of submission of the annual activity report a 990 EZ or 990 for the fiscal year. If you are filing a 990 N you must provide a Profit and Loss Report and Balance Sheet as part of your annual activity report.)
Tithing:
Tithe dollars sent to Fuller Center: ______
IRS 990 Information:
Date of filing of most recent 990 report ______
Board Information:
Number of Board Members at Fiscal Year End______
Number of Board meetings during the past fiscal year ______
Executive Director
Name: ______
Address:______
Phone: ______Fax: ______Cell: ______
Email: ______
Board Chair-President
Name: ______
Address:______
Phone: ______Fax: ______Cell: ______
Email: ______
Vice Chair-Vice President
Name: ______
Phone: ______Email: ______
Secretary
Name: ______
Phone: ______Email: ______
Treasurer
Name: ______
Phone: ______Email: ______
Board Members-Complete list of remaining board members (please attach separate sheet if necessary)
Name: ______
Phone: ______Email: ______
Name: ______
Phone: ______Email: ______
Name: ______
Phone: ______Email: ______
Name: ______
Phone: ______Email: ______
Additional Contact Information (for example Construction Manager / ReUse Store Manager):
______
______
______