Mid-South RC&D Final Report Form

Please use the form below to complete your final report to Mid-South RC&D. If you haven’t heard from us within two weeks, please check with our office.

Please complete this form as accurately as possible as your final report. All invoices, proof of payment and digital photos should either be uploaded here, mailed to 6334 Woodmere Blvd. Montgomery, Alabama 36117, or emailed to midsouthprogrammanager@gmail.com.

DO NOT include information that is confidential or could allow for a stolen identity in uploaded documents or email.

If you are human, leave this field blank.

Project Title

County

Organization

Your Senator's Name

Your Representative's Name

What does your organization do?

Project Category (choose the category that best fits)

Number of People Served

Number of Events

If your project did not host an event, enter 0.

How did you spend the money?

1. Project Amount Received from Mid-South

2. Dollar Amount Received from other Sources (total)?

3. Total Project Value (add lines 1 and 2)

Did Volunteers Donate Time to Project

Yes

Approximate Volunteer Hours

Completion Date of Project

How did the project make an impact in your community? (1 paragraph)

If you have a specific example or personal story from a beneficiary, please share.

Please include the GPS coordinates for your project if at all possible. We'll be mapping our projects in the future. If this project involved multiple locations, please add additional coordinates in the optional comments section if possible.

Project Address fields

Physical Address of Project

City

State/Province

Zip/Postal

Project Latitude (should be a number similar to -86.963240)

Project Longitude (should be a number similar to 34.491349)

Add Remove

First Name

Last Name

Phone

Is this form complete and ready for review?

Yes

You must submit Financial Documents and Photos in order to be reimbursed! All Photos must be in jpeg format. Copies of cancelled checks and or bank statements and corresponding receipts along with photos can be uploaded. Be sure to black out account numbers before uploading and never upload social security numbers or other compromising information. You can also send by mail to Pam Hughes, Program Manager, Mid-South RC&D, 6334 Woodmere Blvd. Montgomery, AL 36117

Drop a file here or click to upload Choose File

Maximum upload size: 52.43MB