Community Services Quarterly Report : Video Training Website Lincoln NE

Please complete all relevant information about your community service ministry.

Information

Quarter

Year

Sponsoring Church(es)

Center

Director

Address

Phone

Program Statistics

A: Clients

Client Demographics Low Income Homeless Single Adults Families Ethnic Group Other

Total Clients Served

Families served

Referrals made to other agencies

B: Food Program

Meals Served

Food bags/boxes distributed

Holiday food baskets distributed

Total pounds distributed

C. Cash Assistance

Dollar value of rent/utilities aid

Dollar value of other aid

Total dollar amount of cash grants

D. Personal/Household Goods

Items of clothing dispensed

Items of linens/bedding dispensed

Items of furniture dispensed

# small household items dispensed

Hygiene kits dispensed

Toys distributed

Other items dispensed

Boxes of goods to other agencies

E. Administrative

Total active volunteers

Total volunteer hours

Total persons screened

F. Personal Growth

Bible study enrollments

Literature distributed

Disaster Preparedness classes offered

Classes Offered

Total class attendance

Additional Activities

Thrift Store Ministry Survey

Name of Store

Phone

Hours of Operation (days and hours)

Manager

Manager's Email

Manager's Phone

Website or Other Media Presence

Number of Volunteers

Volunteer Hours

Gross Sales

Net Sales

Ministries Supported by Thrift Store & Amount Given This Quarter

Any Additional Comments

EXPLANATION OF PROGRAM STATISTIC ITEMS:

Total clients served: Number of individual clients who were served through your programming during the bindicated quarter. If they were served more than once, count each time they were served.
Families served: Number of family groups who were served through your programming during the indicated
quarter. If they were served more than once, count each time they were served.
New families served: Number of families for whom the indicated quarter is the first time they were served through your programming.
Referrals made to other agencies: Any referrals for any services to another entity.
Meals served: This number should include the number of individuals served at each meal offered through your programming. If individuals were served at multiple meals during the indicated quarter, they should be counted for each meal.
Food Bags Given: Boxes or bags of food given to individuals.
Holiday Food Baskets: Boxes or bags of food given specifically at Thanksgiving and Christmas time.
Cash value of food dispensed: This figure is calculated by multiplying the weight in pounds of the food dispensed by $1.50. This should reflect the total amount from the food program including items under B:1-3.
Dollar value of traveler’s aid: Any monetary assistance given including motel lodging, gasoline etc.
Dollar amount of rent/utilities: Dollar amount of monies given to assist with housing costs.
Dollar amount of cash grants: Dollar amount of monies given in form of cash or gift cards.
Dollar value of other purchases: Monies spent on purchases made to meet needs of individuals not already reflected in preceding categories, such as for prescriptions.
Total Dollar value of Cash Grants: This should reflect the values listed in C:1-3 and any other monies given.
Hygiene items Dispensed: This figure includes items such as diapers, toilet paper, toothpaste and deodorant.
Number of other items distributed: Any goods distributed not already reflected in the preceding categories.
Total Active Volunteers: Any volunteer who contributes time to the program on at least a quarterly basis.
Total Volunteer Hours: Total number of service hours contributed to your program/center including time spent preparing for services. For example: if five volunteers served for five hours, the total would be 25 hours.