Return completed report to the National Alliance for Accessible Golf via
Please click cursor in the grey boxes to answer questions. Double-click cursor in grey boxes to complete check-boxes. Please refer to your application and budget forms when completing this report. For assistance, please do not hesitate to contact the Alliance at
DATE OF GRANT REPORT:
Please provide starting and ending dates for this grant:
SECTION 1: GENERAL INFORMATIONOrganization Name (Official/Legal Name)
Name of Golf Program
Mailing Address / City / State / Zip Code
Primary Contact / Title
Contact Phone Number / Mobile Phone Number / Fax Number
E-mail Address / Organization Web Site Address
SECTION 2: Financial Informationfor this grant program only
Total amount of Alliance/USGA grant $
Projected Cash Revenues: $ / Actual Cash Revenues: $Projected Cash Expenses: $ / Actual Cash Expenses: $
Projected In-Kind Contributions:$ / Actual In-Kind Contributions: $
Please describe in detail thedifferences between projections and the actual figures.
Alliance/USGA Grant Amount:
$ / Grant Terms
Item Awarded / Maximum Rate Paid by Grant Funds / Actual
Rate Paid / Total Amount Spent on Item
PGA/LPGA Professional Instruction / $50/hour
PGA/LPGA Apprentice Instruction / $35/hour
Other Instruction / $20/hour
Golf Course Access / $5/round
Driving Range Access / $3/bucket
Golf Clubs & Bags / $200/set
Transportation
Inclusion Activities
Other (please provide detail)
SECTION 3: Staff Preparation/Training
Please complete the information below regarding orientation and training that you provided for staff involved in the grant program:
Did you conduct a training program for staff involved in the program? / yesno
Please describe your orientation/training program? (please attach schedule, specifics)
Please check and describe the training components that were included:
YES / NO / Explanation and/or resources usedDisability awareness
Person first terminology
Inclusion
Use of Adapted equipment
Pace of Play
Golf Etiquette
Golf Skills
Other- please specify
Please identify who conducted the training:
(Provide names, title and affiliation with this program
Please check category and number of staff trained:
PGA/LPGA Professionals / Number / Explanation or additional informationPGA/LPGA Apprentices
USGTF Professionals
Other Golf Professionals
The First Tee Coaches
Amateurs
Inclusion/disability specialists
Volunteers
SECTION 4: PARTICIPANTS SERVED compared to figures in the Grant Application
Number of Participants with disabilitiesthat were projected In youra grant application ______/ Actual number of Participants with disabilities servedduring the grant period
Projected Number of Participants without disabilitiesin grant application ______/ Actual number of Participants without disabilities servedduring the grant period
Add any pertinent information on your participants
Was the grant supported program inclusive, i.e. participants with and without disabilities participating alongside each other? Yes No
Please provide the information requested below: (please include only participants with disabilities benefiting from grant funds)
Please provide as much detail as you can.
Participants served by Gender / Number / Socio-economic background
Male / Household income less than $25,000
Female / Household income $25,000-$50,000
Disabilities served (please break out by physical, developmental, etc. / Household income $50,001-$75,000
Household income $75,001 and above
No Disability
PLEASE USE NUMBERS NOT %
Age
Under age 6 / Ethnicity / Number
6 to 9 / African-American
10 to 13 / American Indian/Alaska Native
14 to 18 / Asian/Pacific Islander
ADULTS (over 18) / Caucasian
Golf Background / w/dis. w/o dis. / Hispanic
No previous exposure to golf / Other:
Beginners skill but not 1st exposure)
Intermediate
Advanced
SECTION 5: PROGRAM IMPLEMENTATION
For the program funded by the Alliance Grant, please complete the chart below.
Program Name / Number of Meetings per Participant / Hours per Meeting / Number of Participants Served in Program / Number of Times Participants Played on Golf Course / Number of Times Participant Used Driving Range / Program Fee / Number of Scholarships Provided
Please complete the chart below related to the instructors that worked with your program.
Instructor Classification / Utilized by Program / Rate Paid Per Hour (Range) / Were these rates discounted from instructor’s typical rate?
PGA/LPGA Professional / Yes No
PGA/LPGA Apprentice / Yes No
USGTF Professional / Yes No
Other Golf Professional / Yes No
The First Tee Coach / Yes No
Amateur / Yes No
Inclusion/disability spec. / Yes No
Volunteer
What was the typical ratio between instructors and participants?_ instructors to ---= participants
Please complete the chart below for up to five opportunities participants had to play golf outside of scheduled programming:
Golf Course(s) Name (Type)
e.g. Rolling Hills Golf Club (9-hole executive course) / Green Fee Rate Paid by Participants / Number of holes in round / Regular Green Fee
(per round)
How many participants played golf or practiced outside of grant funded programming? Estimated Tracked
How many rounds were played by those participants outside of grant funded programming? Estimated Tracked
Please complete the chart below regarding any INCLUSION activities that were included in the program
Name/purpose of Activity
e.g. miniature golf field trip, visit golf equipment store, group icebreaker activities, pizza party with golf club / Number (#) of total participants in the inclusion event or activity including program participants and others / Total cost of inclusion activity / Fees, supplies donated or discounted (yes or no)
SECTION 6: EVALUATION
Did your program formally measure the impact of the program on the participants? Yes No
If yes, please describe the results/significant findings of any outcomes measurement activities. PLEASE- WE WOULD LIKE 2-3 EXAMPLES OF IMPACT ON INDIVIDUALS OR GROUPS IN YOUR PROGRAM (BRIEF NARRATIVE). ALSO, PLEASE FORWARD “ACTION PHOTOS ,” News releases, etc. of the program.
In what ways did your organization collaborate with local golf organizations such as area state or regional golf associations, other junior golf associations, PGA/LPGA Sections and/or other community recreation and rehabilitation organizations? (Identify all collaborative organizations.
We believe that golf can be a significant factor in the health and wellness of participants. Please cite examples of how this grant as added to the health and wellness of participants (please add additional space if needed;
______
______
In what ways has the Alliance support made an impact on your program?
______
The Alliance/USGA is interested in generating awareness of its supported programs via its various communication channels. If you think there may be a good opportunity to write an article about, or otherwise promote one of the participants in your program or the overall success of your golf program, please provide a brief description below or attach.
If desired, please use the space below to provide any feedback to the Alliance on its grants process or application materials, or any other information you feel is important for the Alliance to know about your program’s operation during this grant period. If the information requested in this report does not fully reflect the impact of the program, please add additional information. Thank you.
I hereby verify that all information contained in this report is accurate and fully representative of the program(s) run by our organization. I understand that the completeness and accuracy of this report will be taken into consideration in terms of remaining in good standing with the Alliance/USGA and in the review of any future funding request.
Name:
Title:
Signature: / Date:
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