Project/Patient Assistance Grant – Final Report

Grant recipients are required to submit a final report after the project’s completion. The report must follow the outline below, and must be submitted electronically by April 15 at 11:59 PDT.

FAILURE TO SUBMIT A FINAL REPORT WILL MAKE THE RECIPIENT INELIGIBLE TO RECEIVE FUNDING FOR SUBSEQUENT YEARS’ PROJECTS UNTIL THAT REPORT IS RECEIVED. IF THE RECIPIENT HAS APPLIED FOR AND BEEN AWARDED A GRANT FOR THE FOLLOWING YEAR, THE AWARD CHECK WILL BE HELD UNTIL THE FINAL REPORT IS RECEIVED.

Please note that copies of receipts and other justification of expenses are not required in this submission, however it is expected that adequate documentation would be available in the event of an audit. The Hemophilia Alliance Foundation Board reserves the right to conduct a program and financial audit of documents and finances associated with this grant.

"*" indicates required fields

1. Contact information
6. Financial report: Please reproduce here the original budget, adding a column showing actual expenses.*
Example:
List*
Item
Budgeted
Actual Spent
 
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