Lions Clubs International

Questionnaire

Name of Resource Person: ___________________________________________________________________________

Position:__________________________________________________________________________________________

Address: _________________________________________________________________________________________________

Business Telephone:_________________________________ Fax Number:___________________________________________

Area of Expertise: please check one

___ Educational Services ___ Environmental Services ___ Youth Services

___ Health Services o Social Services o Recreational Services

1. Can you identify specific community service projects in your field that you think are successful? ___No ___Yes

Please list _________________________________________________________________________________________________

_________________________________________________________________________________________________

2. If you answered yes to question one, why do you think the community service projects you listed are successful?

__________________________________________________________________________________________________

__________________________________________________________________________________________________

3a. Can you identify specific needs in your field that, if met, would help service the community? ___No ___Yes

Please describe: ____________________________________________________________________________________

__________________________________________________________________________________________________

3b. How do you think this need can best be met?_________________________________________________________

__________________________________________________________________________________________________

4a. Do you know of any duplication of efforts from volunteers in your service area? Are there two or more organizations

doing the same programs and fulfilling the same needs? ___No ___Yes

Please describe: _______________________________________________________________________________________________________________________

4b. How can the groups work together to eliminate unnecessary duplication or coordinate joint efforts?

_________________________________________________________________________________________________

_________________________________________________________________________________________________

5. Do you feel that residents in this community are aware of the services and facilities offered? ___No ___Yes

Please comment: ___________________________________________________________________________________

__________________________________________________________________________________________________

6. In your opinion, is there room for more volunteer involvement and programs in your service area? ___No ___Yes

Please comment: ___________________________________________________________________________________

__________________________________________________________________________________________________

Additional Comments: _______________________________________________________________________________

__________________________________________________________________________________________________

Date:______________________ Print and return completed survey to:
                                                                                            Snellville Lions Club
                                                                                            Box 292
                                                                                            Snellville, GA 30078
                                                Or e-mail this page to:
                                                                                            maragil39@yahoo.com
                                                           

This site was last updated 02/04/10