Form 1 3 Year Posst Project Survey
Fast Track Generic Clearance for Collection of Qualitative Feedback on Agency Service Delivery
3 Year Post Project Survey
ANA Sustainablility Servicers Survey
OMB: 0970-0401
ANA Three-Year Post Project Target Impact Indicator Services Survey
THE PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13) Public reporting burden for this collection of information is estimated to average 0.08 hours per response, including the time for reviewing instructions, gathering and maintaining the data needed, and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number.
Expiration date: 5/31/2018 OMB Control No: 0970-0401
Section
A)
Impact
Indicators
Please list the impact indicators used in your grant application and the status of those indicators at each point in time.
Impact Indicators
Indicator
Status Prior to the Project (Baseline)
End of Project Target
Actual Change at End of Project Period
Three Year Target (Projected Change)
Actual change at Three Year Target
Was this a realistic impact indicator? If not, why?
Section
B)
Sustainability
To what extent are project activities on-going?
Other/Please provide a description of the extent to project activities:
What were the greatest contributing factors to sustaining project activities?
What were your greatest challenges to sustaining project activities?
Services
What services did ANA provide to better assist with sustainability?
How could ANA better serve you to achieve project sustainability?
If applicable, how has the project data been maintained and/or used?
Did you receive TA at any point during the project period? If so, did it contribute to the level of sustainability?
What would you have changed in planning the grant? (if involved)
What would you have changed in implementing the grant?
Are the impacts of the ANA grant still visible in the community?
Partnerships
at
End
of
Grant
vs
3
Year
Post
Project
#
of new
partnerships at
end of
grant (if
different than
information
provided):
#
of new
partnerships 3
year post
project:
#
of pre-existing
partnerships at
end of grant
(if different
than information
provided):
#
of pre-existing
partnerships at
end of grant:
Top
3 partners
at end
of grant (if
different than
information
provided):
Top
3 partners
3 year
post project:
Level of Funding at End of Grant
No funds
secured
Still seeking
funding
Some
additional funding
secured
Desired level
of funding
secured
No additional
funding needed
Current level of funding
No funds
for project
activities
Seeking funding
for project
activities
Some
funding secured
Desired level
of funding
secured
No additional
funding needed
Beneficiaries at End of Grant vs 3 Year Post Project
Beneficiaries
at end
of grant (if
different than
information
provided):
Additional
Beneficiaries 3
Year
Post Project:
-
Did
your marketing
and outreach
activities change?
-
How
has
project
staffing
changed?
-
Best
practices
to
share
in
regards
to
sustainability?
Program
Area
Specific
(Language)
Please fill this section out if your project was a language grant.
What services can ANA provide to specifically help [INSERT PROGRAM AREA] grantees?
Status of language (if applicable)
Status of language prior to the project:
Status of language at end of grant:
Current status of language:
How was the status determined?
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| File Title | View Survey |
| Author | Zukowski, Amy (ACF) |
| File Modified | 0000-00-00 |
| File Created | 2021-01-22 |
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