Community Vitality Grant Results Report

Recipient Name:

Physical Address:

Mailing Address:

Triangle Phone Number:

E-mail Address:

Contact Person and Title:

Project Title:

Date Project Completed:

Please briefly explain the results of the project (How many benefitted, what is the estimated longevity, were objectives reached, etc.)

We would love to have copies of news clippings, photos, flyers, etc. for our archives.

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Excess Triangle Funds Remaining:

Please attach copies of receipts or proof of payment for any expenses or budget items. If there are excess or remaining funds greater than $10, please reimburse Triangle Communications within ten days ATTN: CVG, PO Box 1140, Havre MT 59501.

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I certify the information provided is true and accurate.

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Community Vitality Grant Results Report

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