Community Partners Impact Report - Due February 1, 2024

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REVIEW PERIOD

The TIME FRAME covered for the February Community Partners Impact Report is:

July 1, 2023 to December 31, 2023, a SIX MONTH PERIOD, for Outcome Measures, and

JANUARY 1 to DECEMBER 31, 2023, a TWELVE MONTH PERIOD, for Demographics.

AGENCY INFORMATION

Agency Name

First and Last Name Executive Director/CEO:

First and Last Name Person Completing:

Email Address Person Completing:

Phone Number Person Completing:

First and Last Name Program Director:

Email Address Program Director:

Phone Number Program Director:

Program Name:

AREA OF IMPACT

Please select the area of impact of your program:

EDUCATION. Children and youth are equipped to learn at every grade and are prepared for success after high school graduation.HEALTH. Individuals and families have access to healthcare, improve their health, or maintain their health.FINANCIAL STABILITY. Individuals and families improve their socio-economic status.

OUTCOMES RESULTS

TIME FRAME FOR OUTCOME REPORTING – July 1, 2023 to December 31, 2023, a SIX MONTH period.

Measuring the success of your agency initiatives is an important part of effectively managing a program. UWGL must be able to show our donors that their contributions are truly making a positive difference in our community. Therefore, part of applying for funding is to offer evidence that what you are doing is effective.

Below we ask you to share what progress you have made in the first half (6 months) of the funding year, toward meeting your targeted program outcomes. What you record here should be the results you have collected for the "anticipated" outcomes you included in your March 1st Initial or Renewal Application. As a reminder, we require a minimum of two (2) outcomes, and a maximum of four (4).

Program Outcomes/Impact from July 1, 2023 thru December 31, 2023

Total Number of Clients (unduplicated) Served in Allen County from July 1 to December 31

	Outcome Desired	Data/Tools Used to Track Progress	# of Clients Receiving Service	# Clients Achieving Desired Outcome	Targeted % Achieving Desired Outcome	Actual % Achieving Desired Outcome	% of Clients Receiving Service
Outcome #1
Outcome #2
Outcome #3
Outcome #4

Comments on Outcome Results:

Optional (250 words or less)

DEMOGRAPHIC REPORTING

TIME FRAME FOR Demographic Reporting is January 1 through December 31, 2023, a TWELVE MONTH PERIOD (calendar year).

Definition:

A client served is a person who received services from your program.
In the case of a program which has membership, count only those who are officially members of the program.
Count unduplicated clients served at your Allen County location, regardless of the clients county of residence.
Count only the clients served through the Program funded by your United Way grant..
If your program/service is offered inside the schools, you may use the zip code of the school.
PLEASE NOTE: The "totals" in each category should be the same from category to category.

Clients Served by Area of Residence

Please input the number of unduplicated clients served from each location listed below. Please count only clients served in Allen County through the funded program. If the clients residence is outside of Allen County and they were served in Allen County, please list their zip code as "Unknown". If your program is offered inside the schools, use the zip code of the school where the service was provided.

Lima/Bath - 45801

Lima - 45802

Lima/Bath - 45804

Lima/Shawnee - 45805

Lima/Shawnee - 45806

Lima/Elida - 45807

Beaverdam - 45808

Gomer - 45809

Bluffton - 45817

Cairo - 45820

Delphos - 45833

Harrod - 45850

Lafayette - 45854

Spencerville - 45887

Unknown

Total Number of Clients Served by Residence (this number should be the same for all categories):

Clients Served by Age

Please input the number of unduplicated clients served from each age category listed below. Please count only clients served in Allen County through the funded program.

0 to 5 years

6 to 18 years

19 to 24 years

25 to 62 years

62 and above

Age Unknown

Total Number of Clients Served by Age Category (this number should be the same for all categories):

Clients Served by Gender

Please input the number of unduplicated clients served from each gender category listed below. Please count only clients served in Allen County through the funded program.

Male

Female

Gender - Other

Gender Unknown:

Total Number of Clients Served by Gender Category (this number should be the same for all categories):

Clients Served with Disabilities

Please input the number of unduplicated clients served from each disability category listed below. Please count only clients served in Allen County through the funded program.

Male with Disability

Female with Disability

Gender-Other with Disability

No Disability/Unknown

Total Number of Clients Served by Disability Category (this number should be the same for all categories):

Clients Served by Race/Ethnicity

Please input the number of unduplicated clients served from each racial/ethnic category listed below. Please count only clients served in Allen County through the funded program.

African American

American Indian or Alaska Native

Asian

Caucasian

Hispanic or Latino

Multi-Racial

Pacific Islander

Ethnicity/Race Unknown/Other

Total Number of Clients Served by Racial/Ethnic Category (this number should be the same for all categories):

Clients Served by Income Level

Please input the number of unduplicated clients served from each income level category listed below. Please count only clients served in Allen County through the funded program.

Above the Federal Poverty Level

Below the Federal Poverty Level

Income Level Unknown

Total Number of Clients Served by Income Level Category (this number should be the same for all categories):

Additional Explanation

Feel free to record any additional explanations you feel would be helpful:

Optional (250 words or less)

AUTHORIZATION

I verify that I have reviewed the information provided and it is accurate and correct to the best of my knowledge.

Agency Executive Director/CEO - First and Last Name:

Agency Executive Director Email Address:

Date Completed:

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