NATIONAL PERFORMANCE NETWORK

MENTORSHIP AND LEADERSHIP INITIATIVE FINAL REPORT —for NPN PARTNERS

Use this form to report on The MLI Only.

(1) Fill out Report on computer (2) Email this final report to

(3) Mail a hard copy of this report with supplemental materials crediting NPN (if applicable)and photos directly relating to the project to NPN. Contact website for current address: http://www.npnweb.org/contact/

A) GENERAL PROJECT INFORMATION

1) NPN Partner Information

NPN Partner: / Phone:
Name of Mentee: / Email:
Job Title: / Report Date: / //

2) Project Information

Agreement ID#: / C / Project Begin Date: / //
Project Title: / Project End Date: / //

B) SUPPLEMENTAL MATERIALS (optional)

Date by which NPN should expect supplemental materials crediting NPN (press, flyers, brochures) and photos: //

C) PROJECT EXPENSES AND INCOME (actuals)

Amounts should only reflect expenses directly related to the project.

1) PROJECT INCOME

TYPE OF INCOME / SOURCES (PLEASE LIST) / AMOUNT
MLI Subsidy / $
Corporate / $
Foundation / $
Government / $
Private / $
Earned (tickets, workshop fees, etc.) / $
General Operating Funds / $
Co-presenter/Community Partner / $
In-Kind / $

TOTAL INCOME

/ $


2) PROJECT EXPENSES (ACTUALS)

TYPE OF EXPENSE (travel, lodging, conference cost, stipend for mentor, workshop cost, etc.) / AMOUNT
$
$
$
$
$
$
TOTAL COMMUNITY FUND EXPENSES / $

D) MLI FUND EXPERIENCE

Your feedback is valuable and candor is appreciated. Please feel free to report on the positives and negatives of the Project.

1) Do you want information to be kept confidential?

2) What were the project objectives? Give three one-sentence objectives.

A.
B.
C.

3) How were the project objectives met/not met?

4) If a mentor was involved, how was your relationship with the mentor?


5) How did the project develop you as a leader?

7) Did the project strengthen your organization? How?

9) QUOTES: (OPTIONAL) NPN collects statements to use in publications. Please mention anything else of importance to you and NPN regarding this project and/or program.

Thank you!

EMAIL TO:

MAIL WITH SUPPLEMENTAL MATERIALS TO:

NATIONAL PERFORMANCE NETWORK

ATTN: PROGRAM ASSISTANT

PH: (504) 595-8008 X209

Contact website for current address: http://www.npnweb.org/contact/

National Performance Network

NPN MLI-NPN PARTNER Final Report

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