Please fill out completely. Agency Name Person Completing Report Your email Your phone number How much did your agency receive from the COVID-19 Relief Fund? Please upload Units of Service Table Has your agency used all of the funds awarded to you? - Select -Yes No If no, why not? Please describe a success story from COVID-19 Relief Funds CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions. Submit Leave this field blank
