Communities Empowering Youth - Community Organization Assessment

General Statement of Purpose for Survey

The purpose of this survey is to gather information from you, as a recipient of the services provided by the organization, for an organizational and community assessment. Your responses will be used to get a clearer picture of the abilities and potential of the organization.

Please select the organization that you support/participate in & will be evaluating with this survey.

	The Black Family Technology Awareness Association
	Ivanhoe Neighborhood Corporation
	P.O.S.S.E.
	Trace’s Place
	W.E.B. DuBois Learning Center

Background Information:

Gender:
Male Female

Age:

	18 - 24			45 - 54
	25 - 34			55 - 64
	35 - 44			65 or Older

Number of years you have lived in this community:

	Less than 1 year			1 – 4 years
	5 – 9 years			10 or more years

Please report if you agree, disagree, or are not sure with the following statements regarding this organization.

		Agree	Disagree	I'm Not Sure
1.	Programs provided by this organization are effective in decreasing at least one of the following conditions that are present in my community: Gang Activity, Youth Violence, Child Abuse / Neglect
2.	Youth programs provided by this organization are well known in my community.
3.	Youth programs provided by this organization are well attended.
4.	The youth programs are at convenient locations.
5.	The mission and goals of this organization are clear and accepted by the community.

6. Check all programs that this organization provides in your community. In your opinion, do you believe these programs contribute to any (or all) of the following - increasing knowledge, improving attitudes, and/or building skills in youth?

Programs	Program Available By The Organization		Contributes to a great extent	Some- what	Not at all	I'm Not Sure
After school programs
Anger management classes
Character education for youth
Child abuse prevention
Intramural programs
Life skills
Mentoring programs
Parent education programs
Residential care for youth-at-risk
Technology Access
Tutorial Services
Violence prevention programs
Wellness programs (exercise, nutrition, etc.)
Young offenders rehabilitation programs

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