an on-going or routine supplementation schedule divided by "semester" (for example, every 6 months). If your organization has more than two distributions per year please copy the table below and create "Supplementation Round #3." Please designate whether the organization or entity responsible for each distribution location is your organization (“my or a partner organization organization”) (“partner organization”). Please record total # of doses given to the indicated beneficiary group for each distribution location. Add additional lines as necessary. Supplementation Round #1 Enter dates of distribution Start Date (mm/dd/yy): End Date (mm/dd/yy): Vitamin A Vitamin A 200,000 IU Albendazole 400 mg Location 100,000 IU Name of Organization (My Org) Distributed Or DOSES to DOSES to DOSES to DOSES to DOSES to ( District and sub Name of Organization (Partner Org) Infants 6-11 Children Non-Target Children Non-Target county) Months Months Groups Months Groups District A / Sub Power of Vitamins (my org) 600 1,200 2,000 County District B / Sub Children Thrive (partner org) 600 1,200 2,000 County TOTAL DOSES DISTRIBUTED TOTAL LOSSES INVENTORY REMAINING IN STOCK Supplementation Round #2 Enter distribution dates Start Date (mm/dd/yy): End Date (mm/dd/yy): Vitamin A Vitamin A 200,000 IU Albendazole 400 mg 100,000 IU Name of Organization (My Org) Location Distributed DOSES to DOSES to DOSES to DOSES to DOSES to Or (District and Sub Name of Organization (Partner Org) County) Infants Children Non-Target Children Non-Target Months Months Groups Months Groups District A / Sub Power of Vitamins (my org) 600 1,200 2,000 County District B / Sub Children Thrive (partner org) 600 1,200 2,000 County TOTAL DOSES DISTRIBUTED TOTAL LOSSES INVENTORY REMAINING IN STOCK Multivitamin Distribution Summary Using the table below, give distribution details of each commodity provided to your organization by Vitamin Angels. This form assumes that your organization is distributing multivitamins throughout an entire project year. Please record total # of doses given to the indicated beneficiary group for each distribution population location. Add additional lines as necessary. Enter distribution dates Start Date (mm/dd/yy): End Date (mm/dd/yy):
an on-going or routine supplementation schedule divided by "semester" (for example, every 6 months). If your organization has more than two distributions per year please copy the table below and create "Supplementation Round #3." Please designate whether the organization or entity responsible for each distribution location is your organization (“my organization”) or a partner organization (“partner organization”). Please record total # of doses given to the indicated beneficiary group for each distribution location. Add additional lines as necessary. Supplementation Round #1 Enter dates of distribution Start Date (mm/dd/yy): End Date (mm/dd/yy): Name of Organization (My Org) Or Name of Organization (Partner Org) Location Distributed ( District and sub county) Vitamin A 100,000 IU Vitamin A 200,000 IU Albendazole 400 mg DOSES to Infants 6-11 Months DOSES to Children Months DOSES to Non-Target Groups DOSES to Children Months DOSES to Non-Target Groups Power of Vitamins (my org) District A / Sub County 600 1,200 2,000 Children Thrive (partner org) District B / Sub County 600 1,200 2,000 TOTAL DOSES DISTRIBUTED TOTAL LOSSES INVENTORY REMAINING IN STOCK Supplementation Round #2 Enter distribution dates Start Date (mm/dd/yy): End Date (mm/dd/yy): Name of Organization (My Org) Or Name of Organization (Partner Org) Location Distributed (District and Sub County) Vitamin A 100,000 IU Vitamin A 200,000 IU Albendazole 400 mg DOSES to Infants Months DOSES to Children Months DOSES to Non-Target Groups DOSES to Children Months DOSES to Non-Target Groups Power of Vitamins (my org) District A / Sub County 600 1,200 2,000 Children Thrive (partner org) District B / Sub County 600 1,200 2,000 TOTAL DOSES DISTRIBUTED TOTAL LOSSES INVENTORY REMAINING IN STOCK Multivitamin Distribution Summary Using the table below, give distribution details of each commodity provided to your organization by Vitamin Angels. This form assumes that your organization is distributing multivitamins throughout an entire project year. Please record total # of doses given to the indicated beneficiary group for each distribution population location. Add additional lines as necessary. Enter distribution dates Start Date (mm/dd/yy): End Date (mm/dd/yy):
Vitamin_Angels_Reporting_Form_Uganda_ENG.docx