Public Museum Final Report Form for Operating Grant FY02

Final Report March 1, 2002 through June 30, 2003

Due by July 31, 2003

Public Museum:

Project Title:	Reference #:

Contact Person/Title:	Phone:

Explain the major benefits of this grant assistance for your museum=s educational programming:

Did the grant assist the museum in creating new educational programs? Yes:_____ No: _____

Did the grant assist in expanding existing programs?	Yes:	No:

Have these grant funds allowed the museum to create partnerships

with schools that could not have been accomplished otherwise?	Yes: No:

Numbers served:	# of Schools	# of Students

Elementary - Middle:

High School:

Total K-12: __________________________________________________________________

Number of University Students:

Number of Teachers Trained:

Other Audiences Served

(Number of Community Groups, Outreach etc) :

Has acknowledgment of DNR/ISM assistance been generated in a museum publication - either related to the project or in an annual report? Yes:	No:

If Yes, include copies of acknowledgment source (annual report, brochure, educational materials, web site etc.)

If No, please indicate when the publication will be complete:

Send publication or information to the Museum Grants Office as soon as acknowledgment is published. (Sample language: "...with the assistance of the Illinois Department of Natural Resources and the Illinois State Museum.")

Public Museum Operating Grant FY02

Expenditures Summary

Cost Breakdown of Major Project Components

Project Component	Purpose	Amount

Total Amount Expended	$

Operating Grant Amount	$

Interest accrued on grant funds	$

Fund Balance	$_______________________

Approved by Designated Museum Official:

Name/Title (Printed):

Signature of Museum Official:

Date:

Return to: Museum Grants Program

Illinois State Museum

502 S Spring St

Springfield IL 62706-5000

(Revised February 2003)