SayPro Community Needs Survey Template: A structured format for gathering data from community members about their key needs.

SayPro Community Needs Survey

Your voice drives change. Help us understand and address the most pressing needs in your community.

Date: ____________________
Community/Location: ____________________

Section 1: About You (Optional)

1. Age Range:
   • Under 18
   • 18-29
   • 30-44
   • 45-59
   • 60 and above
2. Gender:
   • Male
   • Female
   • Prefer not to say
3. Employment Status:
   • Employed (Full-Time)
   • Employed (Part-Time)
   • Self-Employed
   • Unemployed
   • Student
   • Retired
4. Household Size:
   • 1 person
   • 2-3 people
   • 4-5 people
   • 6 or more people

Section 2: Understanding Your Community’s Needs

5. What are the most urgent challenges your community faces?(Select up to 3)
   • Access to quality healthcare
   • Education and learning resources
   • Employment and job opportunities
   • Safe and affordable housing
   • Infrastructure (roads, water, electricity)
   • Food security and nutrition
   • Public safety and crime prevention
   • Mental health and social services
   • Youth and child development
   • Senior citizen support
   • Other: ____________________________
6. How would you rate the quality of the following services in your community?
   (1 = Very Poor, 5 = Excellent)

7. What are the biggest barriers to accessing these services?(Select all that apply)
   • High cost
   • Distance or lack of transportation
   • Limited availability or long wait times
   • Lack of awareness or information
   • Cultural or social barriers
   • Other: ____________________________

Section 3: Prioritizing Solutions

8. If SayPro could address one issue immediately, which would you prioritize?
   • Better healthcare services
   • Improved educational support
   • Job creation and skills training
   • Safer housing and better infrastructure
   • Community mental health support
   • Other: ____________________________
9. Rank the following areas from 1 (Most Urgent) to 5 (Least Urgent):
   • Healthcare
   • Education
   • Job and economic opportunities
   • Infrastructure and basic services
   • Community engagement and support

Section 4: Community Involvement

10. Are you currently involved in any community improvement efforts?

• Yes
• No

11. Would you be interested in participating in SayPro’s community programs?

• Yes
• No

Section 5: Your Voice Matters

12. What specific actions do you believe could improve your community?

13. Is there anything else you’d like us to know about your community’s needs?

Thank You for Your Input!

Your feedback is invaluable in helping SayPro create real, lasting change.

Optional Contact Info (If you want to stay updated on SayPro’s programs):
Name: __________________________
Phone/Email: __________________________