ASHA Reimbursement Issues Grant Mid-Year Report


Provide a brief summary of the current status of your grant project. Please complete each field. You may put N/A if not applicable. The deadline for submission is August 4, 2014.

Note: You must complete this form in one sitting. Therefore, please allow sufficient time as you cannot save your information. You can cut text from other applications (e.g., Word) and paste into this form. Please limit your report to one page.

* indicates required field.

Contact Information

Project Title:*

State Association:*

Project Manager's First Name:

Project Manager's Last Name:

Phone Number:


Project Summary*

You may cut and paste text from Word or a similar application.

President's Signature

The insertion of my name below is proof that I am the president of this association and can attest to the validity of the information contained in this Personnel Grant Mid-Year Report.

President's Signature:*

State Association:*

Today's Date (MM/DD/YYYY):*

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