|   |
| NAME/NUMBER OF ACTIVITY: |
| ACTIVITY DIRECTOR: |
| CARL PERKINS EMPLOYEE: |
| REPORT PERIOD: |
| 1. List the Activity Milestones for this reporting period:
|
| 2. If the Milestones were not achieved, explain why:
|
| 3. List the strategies and target dates for achieving the milestones:
|
| 4. Discuss any problems you are experiencing with meeting these milestones.
|
| Monthly Report | Page 2 |
| 5. Summarize travel for this reporting period:
|
DATE(S)
|
LOCATION
|
PURPOSE
|
# OF DCC PARTICIPANTS
|
| 6. Describe services rendered for the Activity by consultants (include consultant’s name(s):
|
| 7. Summarize the actual events during the reporting period: |
| List all expenditures made during the reporting period: |
| Carl Perkins Employee’s Signature: | Date: |
| Activity Director’s Signature: | Date: |