Community Partner Impact Report

Thank you for participating as a CCHF Community Partner. We look forward to receiving your completed Impact Report detailing how your CCHF grant positively impacted the Canton community.

DUE DATE: Your Community Partner Impact Report is due once all Community Partner Grant funds are expended, but no later than November 30th of the funding year, in order to be considered for future funding.

Contact Information

1) Community Partner Organization

2) Contact Person/Title

3) Phone

4) Mailing Address

5) Email

Objectives

6) How has your organization met the Objectives outlined in your 2025 Community Partner Grant Application? Please be specific.

6a) Who was the specific population served by your Community Partner Grant, i.e. Seniors? Individuals of all ages with disabilities, families etc.

Allocation of CCHF Community Partner Grant Funds

7) How many Canton residents were served?

8) What specific services did they receive?

9) Were other individuals, outside of Canton, served with your Community Partner Grant?

Yes No

10) If yes, who were they and how many were there?

11) What will be the impact of CCHF's Community Partner Grant to your organization on the future health, safety and well-being of the Canton community?

Comments

12) Any additional details you would like to share about your CCHF Community Partner experience?

Verification

By submitting this Community Partner Impact Report, you certify that all information provided herein is true and accurate.

Please enter your initials below to submit this report

Date Submitted

Contributing to the Health, Safety & Well-Being of the Canton Community.

Community Partner Impact Report

Community Partner Impact Report

Contact Information

Objectives

Allocation of CCHF Community Partner Grant Funds

Comments

Verification

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