REPORTING: Funded Projects Pilot; Developing Standardized Forms

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Overview

Coversheet
ProgressNarrative
AddlQuestions
Personnel
Budget

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Sheet 1: Coversheet

Awardee Name (Select)		Select
Last 4 Grant Number		Select Awardee Name
Report Type		End of Year
Date Completed
Project Period Start Date		Select Awardee Name
Project End Date		Select Awardee Name
Budget Period Start Date		Select Awardee Name
Budget Period End Date		Select Awardee Name
Principal Investigator (PI)
PI Email
PI Phone

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Sheet 2: ProgressNarrative

Meeting Objective 1:

Planned Start Date

New Start Date

Objective Status

Select

Planned End Date

New End Date

Objective Percent Complete

Select

Planned Meeting Objective Short Description

Progress Report (Use Alt+Enter for new line if desired)

[Replace bracketed text with your response]

[Replace bracketed text with your response]

Meeting Objective 2:

Planned Start Date

New Start Date

Objective Status

Select

Planned End Date

New End Date

Objective Percent Complete

Select

Planned Meeting Objective Short Description

Progress Report (Use Alt+Enter for new line if desired)

[Replace bracketed text with your response]

[Replace bracketed text with your response]

Meeting Objective 3:

Planned Start Date

New Start Date

Objective Status

Select

Planned End Date

New End Date

Objective Percent Complete

Select

Planned Meeting Objective Short Description

Progress Report (Use Alt+Enter for new line if desired)

[Replace bracketed text with your response]

[Replace bracketed text with your response]

Meeting Objective 4:

Planned Start Date

New Start Date

Objective Status

Select

Planned End Date

New End Date

Objective Percent Complete

Select

Planned Meeting Objective Short Description

Progress Report (Use Alt+Enter for new line if desired)

[Replace bracketed text with your response]

[Replace bracketed text with your response]

Meeting Objective 5:

Planned Start Date

New Start Date

Objective Status

Select

Planned End Date

New End Date

Objective Percent Complete

Select

Planned Meeting Objective Short Description

Progress Report (Use Alt+Enter for new line if desired)

[Replace bracketed text with your response]

[Replace bracketed text with your response]

Meeting Objective 6:

Planned Start Date

New Start Date

Objective Status

Select

Planned End Date

New End Date

Objective Percent Complete

Select

Planned Meeting Objective Short Description

Progress Report (Use Alt+Enter for new line if desired)

[Replace bracketed text with your response]

[Replace bracketed text with your response]

Meeting Objective 7:

Planned Start Date

New Start Date

Objective Status

Select

Planned End Date

New End Date

Objective Percent Complete

Select

Planned Meeting Objective Short Description

Progress Report (Use Alt+Enter for new line if desired)

[Replace bracketed text with your response]

[Replace bracketed text with your response]

Meeting Objective 8:

Planned Start Date

New Start Date

Objective Status

Select

Planned End Date

New End Date

Objective Percent Complete

Select

Planned Meeting Objective Short Description

Progress Report (Use Alt+Enter for new line if desired)

[Replace bracketed text with your response]

[Replace bracketed text with your response]

Meeting Objective 9:

Planned Start Date

New Start Date

Objective Status

Select

Planned End Date

New End Date

Objective Percent Complete

Select

Planned Meeting Objective Short Description

Progress Report (Use Alt+Enter for new line if desired)

[Replace bracketed text with your response]

[Replace bracketed text with your response]

Meeting Objective 10:

Planned Start Date

New Start Date

Objective Status

Select

Planned End Date

New End Date

Objective Percent Complete

Select

Planned Meeting Objective Short Description

Progress Report (Use Alt+Enter for new line if desired)

[Replace bracketed text with your response]

[Replace bracketed text with your response]

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Sheet 3: AddlQuestions

	Conference Information (If the conference has not yet happened confirm current status of the following metrics as applicable.):
	Title	[Replace bracketed text with your response]
	Start Date (M/D/YYYY)
	End Date (M/D/YYYY)
	Location of Conference (venue, city, state or virtual)	[Replace bracketed text with your response]
	Projected Audience
	Type of Audience	Expected Number of Registrants	Method of Selection
	Percentage breakdown of Federal vs Non-Federal Employees [(# Federal Employees/Total # Attendees) * 100]			%
		In-Person	Virtual
	Conference Format (Select "Yes" for all applicable)
	Projected Agenda (may be attached) or provide a list of principal areas or topics to be addressed and speakers
	[Replace bracketed text with your response]
	Describe physical facilities and logistical arrangments
	[Replace bracketed text with your response]
	Justification of the conference(s), including the objectives, the problems it intends to clarify, and any developments it may stimulate; the public health need, timeliness, and usefulness of the conference/meeting to the scientific community
	[Replace bracketed text with your response]
	The following are a list of goals and priorities for the FDA Office of Regulatory Affairs and the Office of Partnerships. Please identify all goals and priorities your conference or meeting is aligned with by selecting Yes in the drop-downs provided for all relevant priorities (there must be at least one item that aligns with the goals of your event.
	This Event will:						Select Yes below for all that apply:
	Improve coordination and communication between FDA and regulatory and public health partners
	Improve regulatory data sharing between FDA and regulatory and public health partners
	Expand availability of tools, systems and equipment for regulatory and public health partners
	Increase knowledge and skills of regulatory and public health partners
	Promote equivalency of regulations between FDA and regulatory and public health partners for FDA-regulated commodities
	Improve quality systems of regulatory and public health partners
	Increased efficiency of FDA and public health partner resource use
	Increase partnerships to enhance public health protections
	Expand collective capability and capacity among partners
	Increase mutual acceptance and reliance on public health partner work, data, and action
	Description of the composition and role of the organizing committee, and provide the names and credentials of key participants in the conference /meeting, including the basis for their selection and documentation of their agreement to participate
	[Replace bracketed text with your response]
	Describe publicizing the conference/meeting to all interested participants and for publishing the proceedings.
	[Replace bracketed text with your response]
	Post-Conference only:
	Enter the number of virtual attendees
	Enter the number of in-person attendees
	List the top performing topics (i.e. which topic session(s) have the most participants interested)
	[Replace bracketed text with your response]
	Enter the number of returning attendees or the number of attendees compared to previous years
			Federal	SLTT	Academic	Industry	International
	Representatives in Attendance (mark "Yes" for all that apply)
			Compliance Officers	Managers	Inspectors	Students	Researchers
	Professions represented (mark "Yes" for all that apply)
	Region (e.g. soutwest, northeast, nationwide, international, etc.)	[Replace bracketed text with your response]
	Post-conference survey: Completion rate		%
	Post-conference survey: Overall feedback results	[Replace bracketed text with your response]
	How did the meeting support the FDA mission?
	[Replace bracketed text with your response]
	Meeting Accomplishments
	[Replace bracketed text with your response]
	Public Heath Impacts (Required)
	Please describe the public health impact of your activities under this cooperative agreement.
	[Replace bracketed text with your response]
	Please describe how your activities have facilitated long-term improvements to the national food safety system under this cooperative agreement.
	[Replace bracketed text with your response]
	Optional: Use this space to report any additional information as needed that was not already reported elsewhere
	[Replace bracketed text with your response]

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Sheet 4: Personnel

		Name (last name, first name)	Title	Project Role	Months Funded (# calendar mos)
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	39
	40

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Sheet 5: Budget

		Expenses	Total Budgeted	Expended to Date	Total Projected Expenses
	1	Total Budget	$0.00	$0.00	$0.00
	2	Total Salary, Wages, and Fringe Benefits	$0.00	$0.00	$0.00
	3	Equipment	$0.00	$0.00	$0.00
	4	Travel	$0.00	$0.00	$0.00
	5	Materials and Supplies	$0.00	$0.00	$0.00
	6	Publication Costs	$0.00	$0.00	$0.00
	7	Consultant Services	$0.00	$0.00	$0.00
	8	ADP/Computer Services	$0.00	$0.00	$0.00
	9	Subawards/Contractual Costs	$0.00	$0.00	$0.00
	10	Equipment/Facility Rental/User Fees	$0.00	$0.00	$0.00
	11	Federal F&A (Indirect Costs)	$0.00	$0.00	$0.00
	12	Other 1 [Replace only bracketed text]	$0.00	$0.00	$0.00
	13	Other 2 [Replace only bracketed text]	$0.00	$0.00	$0.00
	14	Other 3 [Replace only bracketed text]	$0.00	$0.00	$0.00
	15	Other 4 [Replace only bracketed text]	$0.00	$0.00	$0.00
	16	Estimated current obligated funds	$0.00
	17	Carryover I will be requesting	$0.00
	18	New funding request	$0.00
	19	Total Requested for next budget period	$0.00
	20	Additional Budget Comments:	[Replace bracketed text with your response]