Site Visit Report

Name of Applicant Organization*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Date of visit*
Date Format: MM slash DD slash YYYY
Time of visit*

: HH

MM
Reviewer Name*
First Last
Those present at visit*
Project funding is being sought for*
Amount Requested*
Grant Funding Year*
Is there adequate talent in the leadership (board/staff) to make the program a success?*
Is there a probability of sustained change from our involvement – either within the organization or the social problem being addressed?*
Will our involvement help the organization succeed in gathering additional commitment from others?*
How many will be served by this project?*
Is the project being considered reasonable and necessary for the organization to meet its goals?*
- Yes
- No
Does it include multiple funding sources?*
- Yes
- No
Is the fundraising plan for this project thorough?*
- Yes
- No
If yes, please name
Has the organization successfully completed a venture of this size in the past? Give a brief description.*
What is unique or special about this project to you as a reviewer? Does it tell the story in a unique and compelling way?*
Were they knowledgeable about program?*
- Yes
- No
Strengths:*
Are there any concerns of which the Foundation should be aware?*
Recommendations*
- Full Funding
- Partial Funding
- None
- More
Other comments
Signature*

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