The Illinois DeafBlind Project Service Provider/Professional Needs Assessment can be completed by individuals or on behalf of agencies.  Responses are used to support immediate needs and set future priorities. It should take about five minutes, depending on your level of detail. Once a year a $50 Amazon gift card is raffled to all for responded that year who indicate in Question 8 that they want to enter the raffle. Thank you for your time and input, and all you do for children and youth in Illinois!

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* 1. Please tell us about yourself.  Check any/all that apply.

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* 2. Specifically, how do you support the development and education of children and youth? Please check all that apply to you.

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* 3. What is your experience serving children and/youth who are deaf-blind? Please check all that apply.

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* 4. What is your awareness of the National DeafBlind Child Count and the Illinois De-Identified Child Count Reporting System?

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* 5. Which topics below are important to you or your team for professional development? Check as many as apply to you.

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* 6. Which ways do you or your team prefer to receive professional development?  Please select as many ways of receiving information/learning that appeal to you.

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* 7. What factors are relevant to you when choosing professional development activities? Please rank these factors.

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* 8. Would you like to be on our Constant Contact email list to learn about honorariums, trainings, and other opportunities? If yes, please write your name and email below.

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* 9. If you would like to be enrolled in the annual needs assessment responders Amazon gift card raffle, please enter your email below.

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* 10. If you are not making a specific request for professional development, this is your final question.  Is there anything else you would like to say?  Thank you!  If you would like to discuss professional development, please complete Question 10.

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* 11. If you would like to discuss professional development options now, please add your contact information. If you are an individual and not representing an agency, just put an "X" in that space.  Thank you!

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