Research Western

Final Report Form for Western Humanitarian Award

Please provide award recipient details for the following.

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* indicates required fields.

      • Project Title: *
First Name: *
Last Name: *
*Faculty or Unit:
Department or School: 
Email Address: *
Phone Ext (5 digits): 

Final Report Details:

    • Please disclose what was accomplished by receiving these internal funds, and include any anticpated outcomes.
    • Impact on Humanitarian Efforts: *
      Describe how this internal support has progressed your humanitarian efforts, including any future outcomes or development expected. 
    • Benefits to Others: *
      Describe how this internal support has benefitted others and include whether new collaborations were established both nationally and internationally. 
    • Dissemination Activity: 
      Disclose any other dissemination activity arising from this internal support, including conference presentation invitations, website development, generated media exposure and so forth.  
    • Awards and Distinctions: 
      List any award or distinction recognition received as a result of your humanitarian efforts with this internal support. 
    • Additional Comments:
    • b.c.c. Additional Email Addresses:
    • To send a copy of this submission to multiple emails, separate email addresses with only a comma.

    •   Please review your form prior to submission.  Thank you for your final report.