Coastal GasLink Legacy Fund – Interim Report

- Step 1 of 7

Organization Name *

Program Name: *

Report Compiled By: *

Phone *

Email *

Website

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

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SECTION 2: PROGRAM OUTCOME

For Reporting Period

Are you on track for to spend the funds provided by UWNBC as expected per Schedule A of the funding agreement? *

Please explain as we will look for ways to provide support

Do you plan on continuing this program beyond this funding period? *

If yes, do you plan to request funding from United Way? *

For the upcoming year, are you projecting a shortfall or a surplus? What were the circumstances leading to the shortfall or surplus, and in either case how do you plan to address this? *

PROGRAM OVERVIEW: Provide a brief overview of the status of your program to date, identifying any challenges, interesting findings, or feedback of note. *

UWNBC SUPPORT: Do you have an upcoming project / initiative that you would like UWNBC to assist you with, or help promote? *

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SECTION 3: DEMOGRAPHIC IMPACT

FOR REPORTING PERIOD

For any programs that you cannot identify between individuals and interactions due to the nature of your program, please enter the same number under Individuals and Interactions. Ie. A call centre would not be able to identify each individual due to it’s nature, therefore if 100 phone calls were received, this would be recorded as both 100 Unique Individuals and 100 Interactions.

Total # of unique individuals served: *

(counts only each client visit once)

Total # of interactions / visits / interventions: *

(counts when 1 client visits multiple times)

Please indicate any clients that identify as being in one or more of the groups below:
Enter 0 if not applicable

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Children 0-6 years *

Older Children 7-12 *

Youth 13-18 *

Older Youth 19-29 *

Seniors *

2SLGBTQI+ *

Women *

Homeless *

Newcomers *

Indigenous *

Unemployed *

Disabled *

Racialized *

Number of volunteers participating directly in this program/project: *

Number of volunteer hours invested directly in this program/project: *

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SECTION 4: GEOGRAPHIC REACH (FOR REPORTING PERIOD)

What is the geographic reach of the funded project? Please list separately each community and how many Unique Individuals were served.

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Name of the Community Served

Community#1

# Served

Total Served in Community#1

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Community#2

Total Served in Community#2

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Community#3

Total Served in Community#3

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Community#4

Total Served in Community#4

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Community#5

Total Served in Community#5

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Community#6

Total Served in Community#6

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Community#7

Total Served in Community#7

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Community#8

Total Served in Community#8

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Community#8

Total Served in Community#8

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Community#9

Total Served in Community#9

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Community#10

Total Served in Community#10

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SECTION 5: PARTICIPANT QUOTE AND MEDIA

Our donors love to see local imagery as part of our campaigns and partnerships. To be able to show this local impact we are kindly asking for photos and videos of your agency and/or programming that we can share.

Participant Quote:

Please provide a direct participant quote less than 100 words, that describes the funded impact, please include it below. Please do not include any participant identifying information (do not use participant's name - please use an alias).

Quote

Please provide an alias for the above quote:

Media:
Please provide photos, video and/or audio that demonstrate the impact of the funded initiative. Upon request, UWNBC can provide a link where your photos/video/audio can be easily shared. Please provide digital copies of photos in original formatting. The photo/video/audio does not need to include people, but if it does, please ensure consent was given using the 'Media Consent' section below.

Please describe the content of the submitted photo/video/audio, including the file name:

Upload the content (max 35 MB):

Click or drag a file to this area to upload.

If the file size is above 35 MB, provide the link to the cloud storage:

Media Consent
United Way of Northern BC media release and consent statement. By signing this form, you consent to allow United Way of Northern BC to use and disclose the media provided and acknowledge that your media may be shared in printed material, in presentations, in the media, etc.

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Name:

Signature:

Date:

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SECTION 6: FEEDBACK

Please share any feedback you might have for United Way of Northern BC. This can be on UWNBC’s support of your program, the application process, community involvement, etc.

Feedback for UWNBC

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SECTION 7: CONFIRMATION

Confirmation *

I, the undersigned, declare that all information provided is a true summary of the planning, outcomes to date and the intention of the organization.

Program Manager/Contact Name *

Program Contact Signature *

Date Program Contact Signed *

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arshpreetCoastal GasLink Legacy Fund – Interim Report06.29.2023

Coastal GasLink Legacy Fund – Interim Report

SECTION 2: PROGRAM OUTCOME

SECTION 3: DEMOGRAPHIC IMPACT

SECTION 4: GEOGRAPHIC REACH (FOR REPORTING PERIOD)

Name of the Community Served

# Served

SECTION 5: PARTICIPANT QUOTE AND MEDIA

SECTION 6: FEEDBACK

SECTION 7: CONFIRMATION

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