Making effective communication, a human right, accessible and achievable for all.
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Each Year-End Grant Report requires two forms:
Please complete each field. You may put N/A if not applicable. The deadline for submission of the Grant Summary and Expense Form is December 8, 2014. See the ASHA Reimbursement Issues Grant: Procedures and Guidelines for details.
Note: You must complete the Grant Summary 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.
President's First Name:*
President's Last Name:*
Project Manager's First Name:
Project Manager's Last Name:
You may cut and paste text from Word or a similar application.
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 Reimbursement Grant Summary Report.
State Association's EIN Number (The Employer Identification Number is also known as a Federal Tax Identification Number, and is used to identify a business entity.):*
IRS Non-profit Designation (e.g., 501(c)(3)):*
Today's Date (MM/DD/YYYY):*
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