SayPro Stakeholder Feedback Form
Program Name: [Insert Program Name]
Date: [Insert Date]
Prepared by: SayPro
Thank you for taking the time to provide your valuable feedback. Your insights help us ensure that our program effectively addresses the needs of the community and achieves its goals. Please take a moment to answer the questions below. Your responses will be kept confidential.
SayPro General Information
- Name of Organization/Individual:
[Optional] - Role (Check all that apply):
- Community Partner
- Local Service Provider
- Local Leader/Official
- Educator/Trainer
- Other: ________________
- Area of Expertise/Focus:
- Education
- Healthcare
- Mental Health Services
- Employment/Job Training
- Housing/Community Development
- Other: ________________
SayPro Program Relevance and Need
- Do you believe the proposed program addresses a critical need in the community?
- Yes
- No
- Not Sure
- How well does the program align with the community’s current priorities?
- Very well aligned
- Somewhat aligned
- Not aligned at all
- I’m not sure
- What specific community needs do you believe the program will address most effectively?
[Open-ended response] - What other needs should be considered to improve the program’s impact?
[Open-ended response]
SayPro Program Feasibility
- How feasible do you believe it is for the program to be successfully implemented in the community?
- Very feasible
- Somewhat feasible
- Not feasible
- I’m not sure
- What potential challenges do you foresee in implementing this program? (e.g., funding, community buy-in, logistical issues, etc.)
[Open-ended response] - Are there any resources (personnel, expertise, etc.) that would be needed to help implement the program successfully?
[Open-ended response] - Do you believe the program will be sustainable in the long term?
- Yes
- No
- Not sure
- Not applicable
SayPro Program Impact
- How do you think the program will impact the community?
[Open-ended response] - What are the expected long-term benefits of the program for the community?
[Open-ended response] - How would you rate the program’s potential to foster positive change in the community?
- Very high potential
- Moderate potential
- Low potential
- Not sure
- Do you think this program will empower local residents to become more involved in their community?
- Yes
- No
- Not sure
SayPro Stakeholder Collaboration
- How do you perceive the level of collaboration between SayPro and community partners in this program?
- Very collaborative
- Somewhat collaborative
- Not collaborative
- Not sure
- What other stakeholders or partners should be involved to ensure the program’s success?
[Open-ended response] - What role do you think your organization or you personally could play in supporting the program’s success?
[Open-ended response]
SayPro Suggestions for Improvement
- What aspects of the proposed program could be improved or adjusted to make it more effective?
[Open-ended response] - Do you have any additional comments, suggestions, or concerns about the program?
[Open-ended response]
SayPro Final Thoughts
- Would you be willing to participate in the program or collaborate with SayPro in the future?
- Yes
- No
- Maybe
- Not Sure
- Please provide any other feedback or insights you think would be valuable for the program’s design and implementation.
[Open-ended response]
SayPro Contact Information (Optional)
If you would like to discuss your feedback further, please provide your contact information:
- Name: ________________
- Organization: ________________
- Email Address: ________________
- Phone Number: ________________
Thank you for your time and valuable feedback!
Your input is crucial for the success of this program, and we look forward to working with you to create a lasting impact in the community.
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