**Community Partner Survey**

CNCS is a federal agency that provides funding for national service programs including AmeriCorps, Senior Corps, NCCC and the Social Innovation Fund. We are conducting a survey of AmeriCorps grantees and c ommunity partners to assess how our AmeriCorps grantees are working in communities. We received your organizations name and contact information from __[name of grantee organization] __

. We are interested in learning about how AmeriCorps grants have contributed to the development of community partnerships

. Partnerships may entail among other things, shared administrative tasks or functions , joint ventures, membership in professional organizations, advocacy activities on behalf of beneficiaries and primary services for mutual clients. 1. Does your organization currentl y collaborate with

_ [grantee organization] _ a s a partner organization in your community ? Yes___ No___

**If 1=No** 2. Are you familiar with this program’s services and/or staff? Yes___ No___

3. Ar e you aware that ____________ has received an AmeriCorps grant? Yes___ No___ 4. Have you ever served on any community advisory boards, steering committees advocacy groups or other organizations with _________________ Yes _____ No ______ Don’t know

________

**If 1=Yes or 4=Yes**  5. If yes, p lease check the primary area(s) of collaboration that you share with the AmeriCorps grantee organization **Fiscal and management duties** (e.g. f unding projects, p urchasing of services agreements, sharing f acility space , record keeping and managing information sy stems )**Organizational tasks**

(e.g. d eveloping programs or services , p rogram evaluation , s taff training , promotion, c ollaborative w orkshops and c onferences **Service functions** (e.g. client services

– screening, evaluation/assessment, shared intake forms, service plan development, case conference or reviews, referrals **Administrative Tasks** (e.g. formal/informal agreements contracts, legally

mandated collaborative relationships, int eragency committees, collaborative advocacy **Other.** Please describe: __________________________

6. Before this survey , were yo u aware that __ [grantee organization] __ has received an AmeriCorps grant? Yes___ No___

**If 6 =yes:**  7. Is your partnership with [grantee org] a result , in whole or part, of the AmeriCorps grant? Yes __ No ___ 8. In your view , to what degree have the AmeriCorps members helped [grantee org] develop new partnerships with organizations or individuals in the community? Don’t know Not at all A small degree Moderate degree A great degree If 8 >not at all 9. In your view what are the key way s that AmeriCorps members contributed to forming new partnerships? [Open ended response]10. In your view, to what degree have the AmeriCorps members helped [grantee org]

strengthen existing partnerships with organizations or individuals in the community ? Don’t know Not at all A small degree Moderate degree A great degree If 10 >not at all 11. In yo ur view what were the key way s that AmeriCorps members grant contributed to strengthening existing partnerships? [Open ended response] 12. To what degree have the AmeriCorps members worked with community members and other organizations in the community , to id entify needs and strengths in the community? Don’t know Not at all A small degree Moderate degree A great degree 13. To what degree have the AmeriCorps members worked with community members and other organizations in the community to identify resources ? Resources could include, for example, financial, human capital, in

- kind, or legal. Don’t know Not at all A small degree Moderate degree A great degree

**If 6 =N**  **o :**  14. Did you have a partnership or work with this organization prior to [year became grantee ] ? Yes _____ No ______ Not sure_________ I **f 14 =**  **No:** 15. In your view, to what degree has [grantee org] worked to develop new partnerships with organizations or individuals in the community ? Don’t know Not at all A small degreeModerate degree A great degree 16. In your view, to what degree has [grantee org] worked to strengthen existing partnerships with organizations or individuals in the community ? Don’t know Not at all A small degree Moderate degree A great degree 17. To what degree has [grantee org] worked with community members and other organizations in the community , to identify needs and strengths in the community? Don’t know Not at all A small degree Moderate degree A great degree 18. To what degree has [grantee org] worked with community members and other or ganizations in the community to identify resources ? Resources could include, for example, financial, human capital, in

- kind, or legal. Don’t know Not at all A small degree Moderate degree A great degree

**If 14 =**  **Y es:**  19. In your view, to what degree has [grantee org] worked to develop new partnerships with organizations or individuals in the community ? Don’t know Not at all A small degree Moderate degree A great degree If 19 >Not at all 20. How have the extent of the efforts of [grantee org] to develop new partnerships changed since [start of grant]? Don’t know DecreasedStay ed the same In creased 21. In your view, to what degree has [grantee org] worked to strengthen existing partnerships with organizations or individuals in the community? Don’t know Not at all A small degree Moderate degree A great degree If 21 >Not at all 22. How have the extent of the efforts of [grantee org] to strengthen existing partnerships changed since [start of grant]? Don’t know Decreased Stay ed the same In creased 23. To what degree has [grantee org] worked with community members and other organizations in the community , to identify needs and strengths in the community? Don’t know Not at all A small degree Moderate degree A great degree If 23 >Not at all 24. How have the extent of the efforts of [grantee org] to identify needs and strengths in the community

changed since [start of grant]? Don’t know Decreased Stay ed the same In creased

25. To what degree has [grantee org] worked with community members and other or ganizations in the community to identify resources ? Resources could include, for example, financial, human capital, in

- kind, or legal. Don’t know Not at all A small degree Moderate degree A great degreeIf 25 >Not at all

26. How have the extent of the efforts of [grantee org] to identify community

resources changed since [start of grant]? Don’t know Decreased Stay ed the same In creased