A1 - CN Team Nutrition Training Grants

OMB No. 0584-0512

Expiration Date: 3/31/2019

Attachment E – Quarterly Progress Report Form

FY 2017 Team Nutrition (TN) Training Grant

Quarterly Progress Report

Name of State: __________________________________________________

For the reporting period of ___________________ to ___________________

NOTE: This report may be required to be submitted through an electronic platform.

Use additional space as needed to answer each question.

1. Briefly describe what the planned activities were for the report period.

2. Describe major accomplishments for each activity. Include the: activity; date; audience; participation numbers (unduplicated and duplicated); evaluation methods and pre-tested measurement tools. Provide copies of developed materials, if applicable.

3. Describe any deviations from proposed plan; discuss difficulties encountered and solutions developed.

4. Briefly discuss the budget impact and /or costs associated with in this reporting period. Are the actual expenditures (dollars and /or percentage) this quarter in line with what you had planned, per your grant timeline? If not, explain why.

5. List key activities planned for next quarter.

6. Any other unique aspects that you would like to share.

7. Other Comments?

OMB BURDEN STATEMENT: According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0584-0512. The time required to complete this information collection is estimated to average 60 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: U.S. Department of Agriculture, Food and Nutrition Services, Office of Policy Support, 3101 Park Center Drive, Room 1014, Alexandria, VA 22302, ATTN: PRA (0584-xxxx*). Do not return the completed form to this address.