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2. Complete the following form to provide a final report on activities funded by FY21 Operating Support Grants.
   As a partner in community efforts to advance diversity, equity, and inclusion, we are interested in the efforts you are making, the outcomes you are achieving, and the ways that we can continue to support one another. If you have any questions or concerns, contact Jenni Petersen-Brant, Arts & Cultural Affairs Coordinator, at jbrant@cityofdubuque.org or at 563-690-6059.
4. Organization:*
6. Person Completing this Report: *
7. Daytime Phone: *
8. Email*
10. Address1*
12. Address2
14. City*
15. State*
16. Zip*
18. In what ways did your organization advance the caliber of the arts or set an example of cultural leadership in the community in the last year?*
20. Provide a brief outline of your organization's program activities for the FY21 grant period (7/1/2020 to 6/30/2021).*
22. Provide an overview of your organization's marketing efforts for the past year, highlighting specific efforts to market to and include diverse audiences?*
24. Targeted Planning and Outreach*

    Identify whether you were intentional in involving any of the following populations in your planning, marketing, outreach process.

    1. Ages under 18
    2. Ages 18-21
    3. Ages 22-30
    4. Ages 31-40
    5. Ages 41-50
    6. Ages 51-60
    7. Ages 61 and over
    8. American Indian/Alaskan Native
    9. Asian
    10. Bi-Sexual
    11. Black/African American

    1. College Students
    2. English Language Learners
    3. Gay
    4. Heterosexual/Straight
    5. Hispanic/Latinx
    6. Immigrants
    7. International Students
    8. Lesbian
    9. Men
    10. Middle class/income
    11. Multi-Racial

    1. Native Hawaiian/Other Pacific Islander
    2. Persons with Disabilities
    3. Refugees
    4. Trans or Transgender
    5. Unemployed/Fixed Income
    6. Upper Class/Income
    7. Veterans
    8. White/Caucasian
    9. Women
    10. Working Class/Income
    11. Our process was non-targeted
26. Approximately how many adults participated in or attended your FY21 programs or events??*
27. Approximately how many youth participated in or attended your FY21 programs or events?*
29. Provide an overview of any significant demographic characteristics of those involved in producing or participating in this past year's programs such as gender, age, ethnicity, socioeconomic status, etc.
31. Check the degree to which project/program participants were reasonably representative of the demographic makeup of the community*

    1. Not representative of community demographics
    2. Slightly representative of community demographics
    3. Moderately representative of community demographics
    4. Very representative of community demographics
33. Based on your organization's mission and vision, describe what your organization's impact on the Dubuque community over the last year.*
35. Describe any lessons learned, changes or adjustments your organization plans to make, or any unexpected results you had as a result of the activities of your organization during the last year.*
37. What resources (if any) do you need to better achieve your mission in the future?
39. In what ways did your organization incorporate DEI professional development and implementation strategies into your organization's operations or programming in the past year?*
41. Check any ways in which you have participated in Inclusive Dubuque

    1. Regularly attended Inclusive Dubuque Network partner meetings
    2. Shared monthly Inclusive Dubuque newsletters throughout your organization
    3. Actively participated in a working group
    4. Participated in Inclusive Dubuque learning events
    5. Supported employee participation in Inclusive Dubuque learning events as part of professional development
    6. Applied Inclusive Dubuque equity tools to programs and practices
    7. Shared successes and failures with other members of the Inclusive Dubuque Network
    8. Responded to the annual Inclusive Dubuque Member survey
    9. Shared progress reports on equity activities with Inclusive Dubuque
43. In a single PDF attachment, provide evidence of funding recognition given to the City of Dubuque related to this project.
    Examples of funding recognition include press releases, direct mail pieces, email newsletters, etc.
44. Funding Recognition*
46. Upload at least 1 and up to 4 high resolution images from that can be used by the City for promotional purposes.
    It is understood that appropriate photo releases have been secured and copyright is waived related to any of the images uploaded here.
47. Image Credit Recognition
    If photographer credit is required for any of the uploaded images, please provide an additional document noting the filename and the credit notations required.
49. Image #1*
50. Image #2
51. Image #3
52. Image #4
54. By checking the "I agree" box below, I certify that the information contained in this report including attachments, reported expenditure and income, and support materials is true and accurate to the best of my knowledge. *

    1. I agree
56. Signature of person certifying: *
    Entering your name here will be considered an electronic signature.
57. Title: *
58. Date:*
Leave This Blank:


60. 1. Receive an email copy of this form.
61. Email address

    This field is not part of the form submission.

62. Submit

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