FINAL REPORTName of Grant:

Grantee:

Submitted by:

Date:

10 Total amount received from Tri State Educational Foundation

11 Total amount left over (line 9 minus line 10)

12 Amount to be refunded to Tri State Educational Foundation (line 10 minus line 11)

PROJECT RESULTS1 Attach a narrative description of your project results. (to be completed by the person who

implements the grant)

Indicate key activities completed. Describe the impact that this project is having or will have

on students' learning and/or performance.

2 Attach verification from your financial office of the expenses listed above.

PROJECT EXPENSES DOLLARS

(Due within 30 days of expenditures)

FINAL GRANT REPORT

TRI STATE EDUCATIONAL FOUNDATION

POST OFFICE BOX 58

IUKA, MS 38852

TELEPHONE: 662-423-3027

1 $

2 $

3 $

7

8

$

$

4 $

5 $

6 $

9 Total expenses (sum of lines 1-8) $

$

$

$