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IRS'lROC'l'Iœs FOR allPI.ETIM; ~..~ RUwcr/PROJECT GaIL .AaIIEYBIIPJft' fORIIS CJD-16-a, CiJD-16-b, Am CJD-16-c These are ....1 ti -purpose foJ:88, to be CQlt)leted partiall y with the graat application and CCJIII)leted fully for ~-1IDIIII8l and fiDal progress reporbl. Applicants lUSt retain both the partially CQlt)1eted peges aod the ~ pages for subsequent use in the S~-"'IIIUI) and final r8p0rt8. At the tÙle of application. Only pages CJD-16-a and continuation page(s) CJD-16-b will be completed. ColU8lDs 2 and 4 are to be left blank at this stage. Line 1, Grantee Name: Enter name of grantee organization. Line 2, Grant No: Leave blank. Line 3, Pro;ect Title: Enter the project title as used in the grant application. Line 4, Report Time Period: Leave blank. Column 1: On each of the numbered lines (1 through 20) beneath the column heading, enter the Performance Indicators exactly as specified under the "Assessment Requirelllents" in the Program Description section of your Application Kit. List all Indicators, even though some may not be applicable to your specific program. If desired, add optional Indicators. In each of the blocks beneath the numbered lines, enter the estimated annual level of achievement/performance -- for the Indicator cited -- as of the date on which the grant will start. Enter "N/A- if the Indicator is not applicable to your specific program. Column 3: In each of the blocks beneath the numbered lines, enter the projected number to be achieved for the cited indicator during this grant period. For semi-annual report. The report, covering the first six months of the grant period and consisting of pages CJD-16-a, 16-b, and 16-c, (in original only) is due at CJD 20 days after the report period ends. Headings and entries on pages 16-a and 16-b submitted with the application should be copied identically into this report; additionally, complete and add the following: Line 2, Grant No: Enter the grant number cited in the statement of Grant Award. Line 4, Report Time Period: Enter the dates for the first six months of the grant. Column 2: In each of the blocks, enter the actual number (as an update of the earlier estimate in the corresponding block in Column 1) of the annual achievement/performance as of the date on which this grant started. Column 4: In each of the blocks, enter the cumulative year-to-date achievement level. Page CJD-16-c: Complete the narrative in the outline provided on the form. Include signature, date, and telephone number. For final report: The report covering the entire grant period and consisting of pages CJD-16-a, 16-b, and 16-c, (in original only) is due at CJD 20 days after the grant period ends. With exception of the "Report Time Period" and entries in Column 4, all other entries on pages 16-a, 16-b of the semi-annual report should be copied identically into this report; additionally complete and add the following: Line 4, Report Time Period: Enter the dates of the entire grant period. Column 4: In each of the blocks, enter the cumulative year-to-date achievement level. Page CJD-16-c: Complete the narrative in the outline provided on the form. Include signature, date, and telephone number. SEE NEX'l' PAGE FOR EXAMPLE OF COItPLETIID FORM Revised January 1989