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Purchase of Services Grant Reporting Form


  1. 1. Instructions
  2. 2. Report Summary
  3. 3. Reporting: Goals & Outcome Categories
  4. 4. Reporting: Quarterly Expenses
  5. 5. Populations Served- Income Reporting
  6. 6. Populations Served- Race and Ethnicity Reporting
  7. 7. Community Engagement
  8. 8. Participant Outcomes
  9. 9. Race and Equity Assessment & Education
  10. 10. Feedback & Comments
  • Instructions

    1. Reporting Period

      Reports are submitted quarterly and are due on the 15th of the following months: October, January, April, and July. 

    2. Report who benefits from services

      All individuals/households/organizations served are to be reported as new during the first quarter of contract period and only once during the contract year. The report should indicate the number of persons, households, or organizations served each quarter, unless the program serves a designated area.