Form completed by

What were the aims and objectives of your initiative as detailed in your application? *

To what extent have these aims, and objectives been achieved *

How many people benefitted from this project? (Insert Number)

In project location

In other North Carrick communities

In communities outside North Carrick

How many people in each of the following age categories benefitted from this project? (Insert Number)

Please tell us about anything in your original application that you have not been able to deliver and why? *

Please tell us about anything that you have delivered additional to the aims and objectives of your application.

Did you acknowledge NCCBC funding within any publicity materials surrounding the project? If so please describe.

Please attach the following documents.

• Receipted invoices and a copy of a bank statement showing the payments/expenditure.
• A minimum of 2 photographs of the project (Please note these photographs may be used for NCCBC and Scottish Power Renewables publicity purposes and relevant permissions should be obtained before submission. You may be asked to complete another form for SPR)
• A minimum of 2 statements/quotes from beneficiaries of the project

Please note: any part of NCCBC’s funding that has not been used in the project must be returned.