Mobile Teams Monthly Impact Report - One More Child

Anti-Trafficking Mobile Teams Monthly Impact Report

Partner Organization Name*
Address of Organization*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Report Submitted by*
First Name Last Name
Title/Position
Phone*
Email*
What month are you reporting services for?*
Resource Box (RB) Impact (during service month)
# of RB Received from One More Child:
# of RB Distributed by Organization:
Location Distribution
Is the location distribution the same as the address of your organization?
- Yes
- No
Distribution Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Did you distribute RBs at more than one location?
- Yes
- No
Address of Distribution
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Did you distribute RBs at another location?
- Yes
- No
Address of Distribution
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
At your discretion, approximately how many children were impacted?*
Ages 17 and under
At your discretion, approximately how many adults were impacted?*
Ages 18 and over
Volunteer Impact (during service month)
# of Volunteers:
Average Hours Served per Volunteer:
Total Hours Served by Organization During Service Month:
Ex: 4 volunteers x 4 hours per volunteer = 16 volunteers hours total for the month
Additional Notes

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