Community Investment and Impact - Final Report

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 UPDATE

This section provides space for you to tell us what (if any) changes have occurred in the program/initiative in the past year.

Have there been any changes to the program outline initially indicated in your approved application? *

Yes
No

Please describe any other changes made to the initiative you feel the United Way should be informed of. *

Please indicate if there has been a change in demand for the United Way funded initiative since the beginning of the funding period (what you originally expected). *

Please indicate if there has been a change in demand for your overall agency in the past year. *

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SECTION 3: DATA COLLECTION

This section provides space for you to describe your data collection methods.

Please outline how you collect data for your program. Include method (i.e. sign in sheet, taking attendance, etc.), how often you collect the information, and any other information that briefly outlines your process. *

Does your organization use this data for anything other than the UWNBC grant reporting?

Yes
No

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SECTION 4: PROGRAM OUTCOMES

Did you spend the funds provided by UWNBC as per the Schedule A of your funding agreement? *

Yes
No

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

Yes
No

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

Yes
No

Provide a brief overview of the outcomes (positive or negative) of the program, summarize the successes, and learnings, and interesting findings (expected and unexpected). *

What challenges did you face? *

Would you change anything for next time? *

OUTCOMES *

Using Appendix A - Please report TWO to THREE outcomes that are most important or significant to your initiative over the past year. Please use the “Indicators” column in Appendix A to help select the applicable “Outcomes”

Click here to download/view Appendix A.

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SECTION 5: IMPACT

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. i.e. 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 6: GEOGRAPHIC REACH

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 7: STORYTELLING

Help us engage Northerners and increase the amount of dollars raised to distribute to our communities!
This information is used to tell prospective donors about the work they have the opportunity to support. It is also used to report to current donors the impact of their donation. Please keep this in mind when responding.

Many people in our communities don't know what you know or see what you see every day working with vulnerable people. Please think of this as an opportunity to bring awareness to the social issues your organization deals with.

The Impact of Dollar - Help us explain to donors the impact of your initiative through various giving levels. We want to demonstrate local impact and local need. We need your help to do so to help us find further resources for the region. Please be specific.

For example, 'A $25 donation buys bus tickets', is not as compelling or informative to a donor as the following: '$25 buys bus tickets for a mom to use to take her infant to doctors appointments'. This lets donors know that transportation is a barrier to people in your community and that young families are struggling to do something as simple as visit a doctor.

If the dollar amounts are too small, please try to think of them in terms of what portion of a service or need they address.

For example: '$25 can be used to pay for 15 minutes of a 1 hour counselling appointment for a victim of assault'

You can also bundle things together: '$2,500 provides 5 care packages (including clean bed linens, personal hygiene products, and new pajamas) given to women upon arrival at a shelter in addition to 8 counselling sessions'.

You do not need to provide examples for all of the following giving levels. Please select 3 to 5 different giving levels by checking off the boxes next to the giving amounts.

Impact Stories (please provide two)

In 500 words, please tell us an impact story regarding a participant served in the past year of your initiative. We are looking for short, detailed and compelling stories about your primary participants that best explains how involvement in your initiative changes lives. Stories are helpful ways of explaining to donors what types of supports are needed to get individuals and families back on their feet. Short sentences or bullet points are fine as long as the staff's contact information is included for potential follow-up. Please do not include any participant identifying information (if using a participant's name, please use an alias).
An outline you may consider when writing your story includes:

Describe the participant's circumstances at the start of your initiative (needs, barriers, issues)
Explain the initiative components that addressed their issues, needs, or barriers
Describe the participant's circumstances since their involvement in the initiative
Describe how improvements have impacted their life and the community if applicable

Story #1

Please provide the staff contact's name and contact information (phone # and email address) for the above success stories:

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#1 Contact Name

#1 Contact Phone

#1 Contact Email

Story #2

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#2 Contact Name

#2 Contact Phone

#2 Contact Email

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SECTION 8: FEEDBACK

How did we do in creating this form? Does it allow you to adequately report on your initiative and its achievements? Please identify any suggestions you have to improve the reporting form or reporting process:

Continuous Improvement for United Way

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SECTION 9: CONFIRMATION

Confirmation *

I, the undersigned, declare that all information provided is a true summary of the planning, final outcomes, and the intention of the organization. →Please note the signing of this report provides UWNBC permission to use the impact, participant statement and images provided publicly.

After you have completed filling out this form, please review all entries for accuracy. Once you're satisfied with your input, proceed to the fill in the Project Manager/Contact Name section.

Please sign in the designated field. Remember, your signature verifies that all the information provided in the form is accurate and complete to the best of your knowledge.

After signing, please click on the 'Save and Resume Later' button. This will generate a new link for your completed form.

Copy this newly generated link and forward it to your Executive Director for their review and signature. Please note, the form should only be submitted after the Executive Director has reviewed and signed it.

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Program Manager/Contact Name *

Program Contact Signature *

Date Program Contact Signed *

Executive Director Name *

Executive Director Signature *

Date Executive Director Signed *

Community Investment and Impact Program – Final Report

SECTION 2: PROGRAM UPDATE

SECTION 3: DATA COLLECTION

SECTION 4: PROGRAM OUTCOMES

SECTION 5: IMPACT

SECTION 6: GEOGRAPHIC REACH

Name of the Community Served

# Served

SECTION 7: STORYTELLING

Impact Stories (please provide two)

SECTION 8: FEEDBACK

SECTION 9: CONFIRMATION

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