Alberta CAPC CPNP Coalition

Capacity Building Fund

Event Report

Submission deadline: One month following activity

Project Name (Name used for CAPC/CPNP Funding):

CAPC/CPNP Project Number:

Agency Name:

Workshop/Conference/Activity/Event name: Date Held:

# of individuals from the project that attended:

Contact information for presentations:

Cost:

Resources or website relevant to this :

Scale being: 1 not recommended, not valuable, little skill, 5 highly recommend, very valuable, excellent skill 1 2 3 4 5

Would you recommend this to other projects?
How valuable to your work was the activity/event/information?
Please rate the presenters' overall skill, knowledge and presentation.

Comments: How will your project and/or participants benefit from staff having attended this activity?

Comments: Information you would like to share with others about this activity.

Project Name: (Name used for CAPC/CPNP Funding) :

CAPC/CPNP Project Number:

Agency Name:

Workshop/Conference/Activity/Event name: Date Held:

Financial: Please provide an "Actual" budget for the Capacity Building funds your project received.

Submit applicable receipts (copies are sufficient) to the address or fax # below.

Be sure your project is clearly identified in your correspondence.

Funded Capacity Building as per proposal:

Category Budget Actual

Registration fee: $ $

Travel costs (.40/km): $ $

Accommodation costs: $ $

Private Accommodations $30.00/nt

Meal costs: $ $

(Breakfast/Lunch $15.00)

Dinner $25.00 OR Daily $55.00

Speaker costs: $ $

Other costs please identify: $ $ ______

TOTAL $ $

Unused funding amount: $

If under $100 please describe how these funds were used. All funds must be expended before fiscal year end:

Funds cannot be transferred to any other Capacity Building Activity without prior approval!

If there is a significant variance between your budget and actual amounts you MUST contact Diane Sopher to discuss.

Please submit this report within 1 month following your Capacity Building activities, email preferred.

This report may be filled out individually by each person benefiting from the funding or it may be filled out by one person speaking on behalf of the CAPC/CPNP project.

Return to: Diane Sopher

266, 3210 118 Avenue

Edmonton, Alberta

T5W 4W1

780 477-5655 phone

780 477-5655 fax

Alternate fax: 780 474-5041