Agency Semi-Annual Program Evaluation

2019-2020 Agency Semi-Annual Program Evaluation

Complete a separate online form for each program that was approved for funding by United Way of Erie County for CY 2019. This information should be derived from your application for funding. You are only required to report on programs for which you receive United Way of Erie County funding.

Please make sure that you answer each question completely and provided the requested information.

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1 Start 2 Part III - Program Outcomes 3 Part IV- Financial Information 4 Complete

PART I - Agency Information

Today's Date

Month

Day

Year

Agency's Name

Email Address

United Way Funded Program Name

Person completing this form:

Identify the half year covered by this report

1st Half (Jan – June)

2nd Half (July – Dec)

Part II - Client Data - Yearly Half

Total number (unduplicated- not counted in a previous half) clients served in this program for this half utilizing:

Number of Clients Under 18

Of this number for this half please identify:

Number of Clients 18 - 55

Number of Clients 56 and Older

Number of Clients Age Unknown

Number of Female Clients

Number of Male Clients

Number of Clients - Gender Unknown

Location of Residence

Number of Sandusky/Perkins Residents

Number of Huron Residents

Number of Castalia Residents

Number of Milan Residents

Number of Vermilion Residents

Number of Residents - Other Areas

Number of Residents - Area Unknown

Total number of clients served YTD:

Of this number for YTD please identify:

Number of Clients YTD Under 18

Number of Clients YTD 18-55

Number of Clients YTD 56 and Older

Number of Clients YTD Age Unknown

Number of Clients Gender Unknown YTD

Number of Female Clients YTD

Number of Male Clients YTD

Number of Sandusky/Perkins Residents YTD

Number of Huron Residents YTD

Number of Castalia Residents YTD

Number of Milan Residents YTD

Number of Vermilion Residents YTD

Number of Residents - Other Areas YTD

Number of Residents - Area Unknown YTD

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