Your Evaluation Needs Question Title * 1. Contact information Name of Your Organization Your Name Email Phone Number Question Title * 2. Where is your organization located? City/Town State Question Title * 3. Please briefly describe the program/effort for which you would like evaluation support. Question Title * 4. What services are you interested in? Check all that apply. Developing the evaluation section of a new grant proposal Developing a full evaluation plan Interviews Focus Groups Surveys Data Management Data Analysis Developing a Word/PDF Report for sharing results Developing a Powerpoint slide set for sharing results Other (please specify) Question Title * 5. By what date would you like all work on this project to be completed? Date / Time Date Question Title * 6. What is the approximate budget for the program being evaluated?(Please note this question is about the budget for this specific program, not the evaluation budget or the budget for your organization as a whole.) $0-$5000 Between $5000 and $50,000 Between $50,000 and $200,000 Between $200,000 and $1,000,000 Over $1,000,000 Question Title * 7. Who will be using or viewing the results of this evaluation work? Please check all that apply. Leadership at your organization Staff at your organization who are not in a leadership role Funders Board members Program participants/recipients/clients (those served by the program) The public (through social media, news, website, publication, or other outlets) Other (please specify) Question Title * 8. What else is important to know about your evaluation needs, the context of this project, or what you are looking for in an evaluator? Done
