Open Your Heart Grant Closure Form

Your agency agrees to follow OYH requirements for closing out its grant by submitting an application. By completing the closure form, your agency is assuring OYH that your organization has spent the grant funds in accordance with your original request. The form must be completed and unused funds must be sent to OYH within 45 days of the grant’s use to be in compliance with OYH grant requirements. Directions on how to complete this form will be emailed to you. Your agency must complete this form to be eligible for future funding from OYH.

If you have received a grant BEFORE January 1, 2017, you may download a copy of the closure form here: Open Your Heart Grant Closure Form. Please send it by email to Ruby Simmons at rsimmons@oyh.org. (You can also send it by mail, if you do not have access to email or a scanner).

If you have received a grant AFTER January 1, 2017, you have been sent a unique link to access our new online grant closure form. If you need your link again please contact Ruby Simmons at rismmons@oyh.org.

Please note: There is no save option for this online form (to save you from having another username and password). If you would like to draft your answers before filling in this form you can download the questions in a word document below.

Grant Closure Form Preview

For planning and drafting purposes, you can see a preview of the closure form below. You can also download it in Microsoft Word format by clicking here: 2017 Open Your Heart Grant Closure Form PREVIEW

* Indicates a required question.

  • Agency Name *
  • Contact Name *
  • Contact Phone *
  • Contact Email *
  • Grant Award Amount *
  • Amount of Unused Grant Funds (if none, please enter 0) *

If there is there is any part of the grant funding that was not used, please return to Open Your Heart by check to 314 Clifton Ave, Suite C100, Minneapolis, MN 55403.

  • Start Date of Grant Project *
  • End Date of Grant Project *
  • In 1-3 sentences, please tell us how this grant has made a difference. (Please specifically mention ‘Open Your Heart’ in your response so that the context is clear if we share the quote, thank you!) *
  • If you are able to share a personal client story about the impact your organization (ideally with the help of our grant, but does not need to be) has made on them that we can use in our marketing materials, please do so here. If you have an accompanying photo, please attach below. Thank you!
  • FILE UPLOAD: Personal Story Photo (If you have more than one photo, please email them to Ruby Simmons at rsimmons@oyh.org.)
  • FILE UPLOAD: Personal Story Photo Release (Need a photo release form? Download a copy of ours here: http://www.oyh.org/photo-release-form/)
  • If you are in or near the Twin Cities: We often need to provide an ‘impact speaker’ for organizations and companies that donate to us to tell a story about how donations to hunger and homelessness has affected people on a personal level. Has anyone at your organization done this before and could we contact them about speaking for us? Saying yes does not obligate them to participate and we would only inquire about 5 times a year in the fall. If yes, please provide their name and contact information. Thank you!
  • Do you have any volunteer opportunities (on going or one time) that you would like us to advertise?

Please upload any photos of your staff, volunteers or clients (of course, only when safe and you have the permission of the subjects) that Open Your Heart can use in its marketing materials (annual reports, brochures, social media, etc). Please also include a photo release form if their faces are recognizable (if it is the back of their head, or too small to see, you do not need a photo release). Thank you, we really appreciate it! If you have more than four photos, please email them to Ruby Simmons at rsimmons@oyh.org. Need a photo release form? Download a copy of ours here: http://www.oyh.org/photo-release-form/

  • FILE UPLOAD: Photo 1
  • FILE UPLOAD: Photo Release 1
  • FILE UPLOAD: Photo 2
  • FILE UPLOAD: Photo Release 2
  • FILE UPLOAD: Photo 3
  • FILE UPLOAD: Photo Release 3
  • FILE UPLOAD: Photo 4
  • FILE UPLOAD: Photo Release 4
  • Any other comments?

General Survey Questions

These questions are unrelated to your specific grant request. They will help us keep up to date on the needs of food and shelter providers in Minnesota.

  • What Continuum of Care region are you a part of? (Dropdown)
  • How do you rate the overall quality of services for hungry and homeless people in your Continuum of Care region? (Excellent, Good, Ok, Poor, Very poor)
  • What are the top two reasons you see people needing emergency services? (Mental Health Problems, Physical Health Problems, Lack of affordable housing, Job loss, Problems with people they were living with, Relocation, Domestic Violence, Short term shelter loss, Health emergency, Other)
  • What are the top two barriers to accessing emergency services in your area? (Awareness of options, Transportation, Lack of time, Child Care, Pride, Safety, Shelter at capacity (program full or does not have enough resources), Fear of accessing resources, Other)
  • What kinds of additional services would you like to see in your region? Do you see any gaps in services in your region?
  • What services or areas of your work are the hardest to receive funding for?