Affiliate Mini-Grant Final Report

If you are not able to complete the report in one session, click the “Save and Continue Later” link at the bottom of each page. You will receive a unique link to continue later, which will only be valid for 30 days.

Today's Date(Required)

What is the entry ID of your minigrant application?(Required)

This should be the 4 digit number that was on your grant application confirmation email.

Affiliate Name(Required)

Grant amount awarded(Required)

Please enter a number from 0 to 500.

Name of person filling out report(Required)

First Last

Email(Required)

Enter Email Confirm Email

Phone(Required)

Did you register and report an event as part of this grant in the online Pick Up PA Report Form?(Required)

Yes

Thank you for reporting! Please enter your Event ID from your Pick Up PA registration.(Required)

What was the name of your project that used the mini grant funds?(Required)

What was the date of your event?(Required)

For approximately how many hours did your event last?(Required)

Please enter a number from 1 to 50.

How many volunteers participated?(Required)

Enter 0 if this was not a volunteer event.

Please enter a number from 0 to 300.

Type of event(Required)

Illegal Dump Cleanup

Education Event

Special Collection/Recycling Event

Beautification Event

Other

What were the project's goals or purposes?(Required)

What were the project's outcomes?(Required)

Please use numbers if appropriate, ex: number of trees planted, number of trash bags of litter, number of people educated, etc.

Did you create any promotional materials or merchandise?(Required)

Yes, I created promotional materials or merchandise, such as t-shirts, press releases, fliers etc. and I recognized KPB as a sponsor/ an affiliate.

No, I did not create any promotional materials or merchandise, such as t-shirts, press releases, fliers etc.

Please upload photos from your event plus any press releases or earned media.(Required)

In the file names, please include your organization or project name so we can match them with your report. Pictures may be used by KPB in press releases, and social media, and other promotions.

We'd love to highlight your project in our newsletters, social media, and on our Affiliate Fund page!

Drop files here or

Max. file size: 128 MB.

Did you secure any matching funds for this project?(Required)

Yes

If so, from who did you secure matching funds and how much?(Required)

Please note that if KPB is your fiscal sponsor, and your event received in kind support, you must submit proper documentation for tax purposes. This includes donor or vendor name, address, donation description and fair market value.

This currently applies to:

Keep Cambria County Beautiful
PA CleanWays of Elk County
Keep Fayette County Green
Keep Huntingdon County Beautiful
Keep Perry County Beautiful
PA CleanWays of Mifflin County
PA CleanWays of Venango County
Keep Reading Beautiful
Keep Royal Gardens Beautiful

Is KPB your fiscal sponsor and if so, did you receive in-kind donations?(Required)

KPB is not my fiscal sponsor

KPB is my fiscal sponsor, but I have NOT received in-kind support for this event

KPB is my fiscal sponsor, and YES I have received in-kind support for this event

Please upload your in-kind documentation.(Required)

For tax purposes, proper in-kind donation documentation is required. This includes donor or vendor name, address, donation description and fair market value.

Drop files here or

Max. file size: 128 MB.

Applicant signature(Required)

By typing your name here, you are signing the report and confirming that the information provided in this report is complete and accurate to the best of your knowledge.

Today's Date(Required)

For questions, please contact Kylie McCutcheon at kmccutcheon@keeppabeautiful.org or 724-836-4121 ext. 114.