2020 Final Report

Grant recipients are required to submit a final report on completion of the project The report must follow the format below, and must be submitted electronically by March 15, 2021 at 11:59 PDT to info@hemophiliaalliancefoundation.org.

As you will see below, this form also serves as a vehicle to request project and budget amendments, and to request a deadline extension. These requests should not be made lightly. The Hemophilia Alliance Foundation Board expects projects to be completed in the grant-year timeline. However, we recognize that unanticipated circumstances may arise, and for this reason we will entertain requests for project, budget, and/or deadline changes. Failure to submit a Final Report will result in ineligibility to apply for a grant the following year.

1. Applicant Type*
2. Contact information
a. Name of organization*
b. Name of main contact*
d. Email of contact person*
f. Phone # for contact person*
c. Name of backup person*
e. Email of backup person*
g. Phone # for backup person*
3. Total # of patients, families, staff or organization (ie software purchase) were impacted by this grant funding. Please be as accurate as possible.*
4. Amount awarded*
5. Did you change the grant project due to COVID-19 impact?*
- Yes
- No
6. Project Description. Please describe how you completed the project as planned or modified due to COVID-19 impact.*
7. Briefly describe project outcomes and knowledge gained from project that can be shared.*
8. Unused funds. If you have unused funds from this project, how much is it and why? If you have used all funds, put $0.*
9. Financial report: Please reproduce here the original budget, adding a column showing actual expenses.*
EXAMPLE:
Budget Report

Item Budgeted Actual Spent
Note 1: After clicking the “Submit” button below, a notification email will be sent to the Contact Person’s email address that includes a copy of your report in PDF format. The PDF will be attached to the email.
Note 2: If, after submitting the form, you don’t receive a notification email in your Inbox, then please
check your spam folder and whitelist the email address “info@hemophiliaalliancefoundation.org”.

Item	Budgeted	Actual Spent