Military ASG Grant Programs Quarterly Report Questionnaire FY20
1. Military Program Name
2. Address where services were rendered
2nd Quarter, January - March 2019
3rd Quarter, April - June 2019
4th Quarter, July - September 2019
4. Number of unique Veterans served this quarter (completed 6 week individual session or 8 week group) Completed or in progress
5. List the first and last name and zip codes for each unique veteran served this quarter and whether completed or in progress and Individual or group session. Example: Janet Crandall, 84655, In Progess 4 Group session completed; Example: Joe Crandall, 84655, Completed All 6 Individual Sessions
6. Number of hours spend in direct personal interaction this quarter with Veterans under this grant
7. Did you have any Veterans drop out of services (incomplete services)?
8. Provide the following for each Veteran who dropped out this quarter
9. Provide the following for each Veteran who dropped out this quarter
10. Provide the following for each Veteran who dropped out this quarter
11. List referral agencies you've collaborated with this quarter. (Please specify exact Agency/VA name, e.g. VA Portland Health Care System)
12. For reach agency listed above, Describe activities conducted in partnership or in collaboration.
13. Check each outreach method you've utilized this quarter (check all that apply)
Press release/local media coverage
social media posts/announcements
email outreach with flyer
Contact with local VA (required)
Demonstration/open barn invitation
14. Please describe any success stories - An anecdotal account of how grant funds impacted any aspect of a Veteran with disabilities or member of the Armed Forces’ life by demonstrating their strength to overcome their respective disability and reintegration into the community through participating in adaptive athletic activities. Who are what was involved? What happened? What were the results? Why was it a success story?
15. Outreach Activity - An account of how outreach activities were conducted to affect awareness and effectiveness of grant- and non-grant-funded adaptive sports activities for Veterans and Service members with disabilities. Who are what was involved? What happened? What were the results?
16. Please describe any challenges-issues: Share any challenges or issues you have faced throughout the grant cycle. Explain what the challenge or issue was, how you were impacted, and how we could/can help.
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