Missouri Service-Learning Advisory Council - DOC

							                              Saskatoon Health Region
                             Community Grants Program

                                School Mini Grant
                          FINAL EVALUATION

Project Name

School Name

School District

Address



Contact Name                                          Contact Title
Contact Phone                                         Contact Fax
Contact Email


Which of the following theme area(s) did your project address? Please check all that apply:

      Healthy Eating                                  Mental Well-Being
      Physical Activity/Active Living                 Injury Prevention
      Reduced Substance Use/Abuse



Number of youth involved in project:
Grade level(s) of youth involved in project:



Total amount awarded:                      $ 200.00

Total funds spent:                         $




                                                                      Please turn over …   
1.   Evaluate your project:

     To what extent did you achieve the goal(s) you set out to accomplish?

      failed to meet                         met                             far exceeded

           1               2               3                 4               5


2.   Measure your results:

     Based on your original goals and objectives, rate the impact your program had on
     the intended audience.
          poor                               fair                             excellent

           1               2               3                 4               5



If you were to do your project again, please describe what you would do differently.




Signature:                                             Date:




                                   Please return to:
                              SHR – Community Grants Program
                             Attention: Administrative Assistant
                                         Box 1930
                                  Humboldt, SK S0K 2A0
                        Phone: (306) 682-8190    Fax: (306) 682-3596
                  email: communitygrantsprogram@saskatoonhealthregion.ca