CHEVRON
PROJECT REPORTING FORM
Please complete all of the information requested and email the completed form to [email protected].
Today’s Date:
Name of Reporting Organization:
Project Title:
Project Implementation Start Date:
Project Implementation End Date:
Amount of Chevron Funding Received:
Date Funds Received:
Reporting Period:
6-month Interim Report
Total Project Funds Expended:
Final Report
Total Chevron Funds Expended:
Please answer the following questions in detail:
1. According to your proposal, what goals were set for completion during the period covered
by this report? Please list each goal expected be achieved (and state whether it was
achieved).
2. How did you track and/or measure success during this period?
3. Based on your tracking/measurement system, were you successful in reaching your goals
during the period covered by this report?
4. How were Chevron funds used/leveraged in relationship to your overall budget to
accomplish your goals during the period covered by this report?
5. Please list additional funding sources and amounts of funding (be sure to include in-kind
donations as well). You may add additional rows as needed.
FUNDING SOURCE
1.
2.
3.
4.
5.
AMOUNT OF CONTRIBUTION
6. If any goals were not accomplished, please explain what happened/why these goals were
not achieved (i.e., include any unexpected or unforeseeable barriers to accomplishing your
goals if any exist).
7. If you were not able to accomplish your goals during the period covered by this report, how
do you plan to accomplish such goals? When will they be accomplished? Is your overall
objective/plan still on track? Please be specific.
8. How did the accomplishment of your goals impact the population you serve? Please be
specific and include stories that illustrate better than expected outcomes where they exist
(or even expected outcomes that demonstrate success and/or the accomplishment of
goals/objectives).
9. What were the lessons learned (e.g., could you have done things differently, more
efficiently and/or how could you improve in the future)?
10. Based upon what you have experienced, is there anything that you will do differently
in the next period (i.e., between this report and the next report that you be filing with us)?
If so, please explain. Will such change(s) impact your goals and/or your budget? If so, how?
11. What tangible and intangible results were achieved and/or delivered (e.g., how many
people benefitted by category of assistance provided)?
12. What was the impact that was achieved, both on individuals and in the community (i.e.,
please explain the impact of your results)?
13. How are you making your relationship with Chevron visible to the broader community (i.e.,
publicity – social media, press release, web site, organizational communications,
volunteering opportunities for Chevron employees, etc., and were these activities approved
by Chevron)?
14. Is there anything else you would like to tell us about your project (i.e., comments such as
why results were higher or lower than expected, organization’s future plans, etc.)
15. Please submit a detailed income and expense statement for this project.
We are interested in, and want to share your success. Therefore, organizations are
encouraged to attach a human interest story (or two or many such stories) that reflects the
value of the project as well as any materials related to the project, such as brochures
produced, press earned, or photos taken. [Note: Anything that is provided to Chevron shall
become the property of Chevron and Chevron shall have no obligation to return such
property.]
Target Metrics 2016
1. On what date do you expect the project or program to be completed?
2. Please complete the ‘end of year 1’ target column below for the proposed project or program. If the
program is expected to last longer than one year, please also complete the ‘end of project target’
column. See the ‘definitions’ section for explanations corresponding to the numbered notations.
NOTE: not all metrics will be applicable to your project. If a metric does not apply, simply mark ‘0’
on the relevant line.
General Metrics
End of
proposed
project
target
End of
actual
project
target
End of
proposed
project
target
End of
actual
project
target
# of direct project beneficiaries in total1

% female
# of indirect project beneficiaries2
Total # of Chevron volunteers on project/program
Total # of Chevron volunteer hours on project/program
# of government institutions or nonprofit organizations with enhanced
capacity as a result of the project (please list)3
# of positive media mentions for the project which mention Chevron
Did the project receive any public awards - if so, how many?
Will this project have a significant public event? If so, how many people will
attend the event(s)?
Amount of cash funds (in US$) leveraged through partnership4
Amount of in-kind contribution leveraged through partnership4
STEM Education Metrics
# of additional resources made available and details of what they were
# students participating in supported project
# of scholarships awarded
# of teachers trained
# of hours of teacher training
# of parents/community members engaged
% of project serving students from low-income families
# of supported students interested in pursuing further STEM education,
certification or career
# of supported students accepted into a post-secondary STEM program
% change in supported student performance in national standard tests in
STEM subjects
Career Training Metrics
End of
proposed
project
target
End of
actual
project
target
End of
proposed
project
target
End of
actual
project
target
# of individuals starting workforce development/vocational training
# of individuals completing workforce development/vocational training
# of hours of workforce development and vocational training provided
# of teachers or trainers participating in professional development or “trainthe-trainer” programs5
# of trainees getting a job as a result of receiving training
# of trainees earning higher incomes as a result of the program
# of individuals certified or accredited in a skilled trade
Micro and Small Business Support Metrics
# of local businesses supported
# of local business owners and employees who started training
# of local business owners and employees who completed training
$ amount of total loans provided
Total # of loans provided
# of local businesses reporting the ability to generate higher revenues after
completing Chevron-supported project
# of total employees in supported local businesses6
# of additional jobs created as a result of the Chevron funding
# of local businesses completing Chevron-funded supplier development
projects that become vendors for Chevron
Definitions
No. Metric
Definition
1
# of direct project
beneficiaries
2
# of indirect project
beneficiaries
3
# of government
institutions or
nonprofits with
enhanced capacity
Amount of cash funds
(in US$)/ in-kind
contribution leveraged
through partnership
The number of project beneficiaries is the # of people that are directly
impacted by the project. It is the number of people who receive the
direct outputs as a result of Chevron's funding.
Indirect beneficiaries are those who benefit due to the positive impact
on the direct beneficiaries. (Example: The number of students in the
class of the teacher who was trained as a result of Chevron's funding
or the number employed by the SME receiving a micro-loan.) Only
count individuals directly impacted by the direct beneficiary.
Number of external groups that are more effective as a result of
training provided through a project.
4
5
6
# of teachers or
trainers participating in
professional
development or “trainthe-trainer” programs
# of total employees in
supported local
businesses
Leveraged funds are all funds that were contributed as a result of
Chevron's funding to the project. The additional funding must have
come as a result Chevron's investment; it is not simply other donations
provided to the partner or project.
In-kind contributions are any non-cash goods or services provided to
the partner to support the project. Describe each good or service
provided and indicate their value, if known. Estimate if exact value is
not known.
Number of trainers participating in workshops or programs that are
designed to make them effective instructors in their skill area.
(Example: Welding workshops, university-level engineering programs,
truck driving certification programs, agricultural training, etc.)
Total number of individuals that are working for the businesses that
are participating and benefiting from this project. (For instance, if the
project benefits 2 businesses – 1 with 3 employees and the other with
5 employees – then the number of employees in the supported
business would be 8.)