Community Literacy Survey

Thank you for participating in the Polk County Reading for All Literacy Survey! The Reading for All initiative of The Oregon Community Foundation, originally created by the Marion County Children and Families Comission, is a community initiative seeking to increase the community's awareness of the importance of literacy, encourage parents to read to their children and align community resources to stregthen the opportunity for more children to receive books and have adults read to them.

Literacy refers to “An individual's ability to read, write, and speak in English, compute and solve problems at levels of proficiency necessary to function on the job, in the family of the individual and in society” (US Dept. of Education).

Our goal with this survey is to learn about what is happening, both formal and informal, around increasing literacy in Polk County. Local efforts may range from programs in libraries to faith based organizations to child care centers. Examples may be as structured as tutoring agencies, afterschool progams, or as simple as a community member who volunteers to read to children.

Please complete the survey below for each program you have that includes a literacy component.

“The more you read, the more things you will know. The more that you learn, the more places you'll go.” - Dr. Seuss, "I Can Read With My Eyes Shut!"

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1. What is the name of your organization?

What is the name of your organization?

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2. Please indicate your type of organization.

	Business	Community Agency	Faith Based Organization	Library	Non-Profit	Public Agency	School	Service Group	Other
Organization Type:	*Please indicate your type of organization. Organization Type: Business	Organization Type: Community Agency	Organization Type: Faith Based Organization	Organization Type: Library	Organization Type: Non-Profit	Organization Type: Public Agency	Organization Type: School	Organization Type: Service Group	Organization Type: Other

Other (please specify)

3. If your program includes a literacy component, please provide contact information for it here.

If your program includes a literacy component, please provide contact information for it here. Contact Person:
Address:
City/Town:
ZIP/Postal Code:
Website
Email Address:
Phone Number:

4. Please provide a name and very brief description of your program.

Please provide a name and very brief description of your program.

5. What literacy services does your program provide? (Check all that may apply)

What literacy services does your program provide? (Check all that may apply) Book Collection Book Distribution Distribute Literacy Materials & Handouts Home Vists Literacy Awareness Events Literacy Classes	Literacy Training for Childcare Providers Literacy Training for Parents Provide and/or Train Volunteers Tutoring Services Other
Other (please specify)

6. What areas of the county does your program serve? (Check all that may apply)

What areas of the county does your program serve? (Check all that may apply) Dallas Falls City Grand Ronde Independence Monmouth	Perrydale West Salem All of Polk County Other
Other (please specify)

7. Target Age Group:

Target Age Group: Birth to Preschool

Preschool

K-3rd Grade

4th-5th Grade

Middle School

High School

Adults

8. Does your program target a special population? (Check all that may apply)

Does your program target a special population? (Check all that may apply) Homeless Limited English Speaking Low Income Minorities Parents	Single Parents Students At Risk of Dropping Out Unknown Other
Other (please specify)

9. How frequently does your program provide its services?

How frequently does your program provide its services? Daily Weekly Bi-Weekly Monthly	Quarterly Annually Other
Other (please specify)

10. Is your program research or evidenced based?

Is your program research or evidenced based? Yes

Unknown

11. How many paid staff members does your program have?

How many paid staff members does your program have?

12. How many volunteers does your program have?

How many volunteers does your program have?

13. Are the volunteer hours tracked or recorded?

Are the volunteer hours tracked or recorded? Yes

Unknown

14. What is the number of individuals your program serves annually?

What is the number of individuals your program serves annually?

15. What supports would help your literacy program be more successful? (Check all that may apply)

What supports would help your literacy program be more successful? (Check all that may apply) Community Awareness/Publicity English Books Spanish Books Financial Resources	Volunteers (Recruitment & Training) Space Other
Other (please specify)

16. Are there other literacy efforts in the community that you think we should be aware of? If so, please provide us with any contact information you may have.

Are there other literacy efforts in the community that you think we should be aware of? If so, please provide us with any contact information you may have.

17. What other needs do you see within the community in regards to literacy?

What other needs do you see within the community in regards to literacy?