(taken from Survey Monkey – to be adapted and tailored to meet the needs and circumstances of the Neighbourhood or Community House)
1. What organisation do you work for?
2. What made you think you should get involved in this project/ program /activity?Please ratethese in the order you thought were most effective in engaging you as a partner where 1 isthe most effective.Only numberthosestrategies that youresponded to.
Networking via meetings and seminars
Word of mouth N/A
Direct contact with your organisationN/A
Advertisements in the local media N/A
Social media N/A
Attending your service or activities/events N/A
3. What work have you done with the Community / Neighbourhood House? Please selectall which apply.
Supported community members in partnership?
Group work?
Referring people to the House?
Taking referrals from the House?
Co-facilitating events?
Working on information strategies?
Other- please provide details
4. Ifyou received referrals from the Housewere those referralsappropriate?
yes
no
If 'no', pleasetell us whyno
5. We would like to know if there have been any changes to the way you deliver your service as a result of this project /program /activity. Below is a list of potential changes which may have happened.Please tick any you have observed in your service as a result of this project /program /activity
New partnerships or collaborations
New shared resources with other services
New ways of delivering services
Increased knowledge of other services
Reduced duplicationof services
Greater flexibility torespond to families
Innovative approaches to delivering service
Other (please specify)
6. What has worked well about thisproject /program /activity?
7. What could have been done differently?
8. How satisfied have you been with this project?
Very dissatisfied / Dissatisfied / Can take it or leave it / Satisfied / Highlysatisfied9. Is there anything else you would like to say about the House or the project /program /activity?