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Lincoln-Lancaster County Health Department
Environmental Public Health

Final Report Form


Final Reports are required for both Neighborhood Association and Community Improvement Grants and are due no later than one month after completion of a cleanup project. Grant awards are not distributed until Final Reports are submitted and approved.

Name of Group:
Contact Person:
Phone Number: E-mail Address:
Mailing Address:
City/State/Zip:
Date Project Completed:

Number of Volunteers (including planning and organization):
Total Volunteer Hours*:
*Total person-hours spent planning, organizing and implementing the project. Example: 2 people spent 4 hours planning and 10 people spent 2 hours implementing the project. Total hours are 28 [(2x4)+(10x2)=28].

Area Cleaned:
Size of area cleaned*:
*Best estimate of acres or length of street/road in blocks or miles.

Materials Cleaned Up
Item Amount Units
Garbage/Trash
Paper
Plastic
Aluminum
Glass
Scrap Metal
Appliances
Batteries
Tires
Brush
Other
Other

Other Organizations Involved:

In-kind Contributions and Donations (food & drink, tools, vehicles, gas, printing/advertisement, etc.)
Item Value
$
$
$
$
Total $

Project Description: Provide a brief description of the completed project. Include how the project benefits public areas, how waste was properly disposed of, opportunities for education and other relevant information. Attach additional pages if necessary.

Award Use: Provide a brief description of how the Community Improvement Grant award money will be used.

KLLCB PROGRAM EVALUATION

How can KLLCB better serve the community in future projects?

Ideas and suggestions for improvement:

Additional comments:

Pictures and volunteer waivers MUST be submitted with the Final Report

By checking this box you confirm the information in this report is accurate. Incomplete applications will be returned.

Thank you for keeping our community clean, healthy and safe!
Partial funding for this program is provided by the Nebraska Department of Environmental Quality


InterLinc City of Lincoln Departments Category Location

Health Environmental Public Health Environmental Quality KLLCB