Communities In Schools Administration/Faculty/Partner Survey

CISGC Program Evaluation

The purpose of our evaluation is to gather useful information so that we can continuously improve our services. Your feedback is important and it is appreciated!!

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* 1. Full Name

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* 2. School/Organization

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* 3. Have you received information on CIS and implemented program services with the students you work with?

Yes, I have received information and implemented their services.

Yes, I have received information, but I have not implemented their services.

No, I haven't received any information about CIS or the services we provide.

Other (please specify)

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* 4. Are you aware of the process to refer students to CIS? Do you have a referral process in place?

Yes, I am aware of the referral process and there is one in place.

Yes, I am aware of the referral process, but there is not one in place.

No, I am not aware of the referral process.

Other (please specify)

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* 5. Does CIS help students you work with in the following areas?

	No Help	Neutral	Some Help	Very Helpful
Grades/Academics	Grades/Academics No Help	Grades/Academics Neutral	Grades/Academics Some Help	Grades/Academics Very Helpful
Attendance	Attendance No Help	Attendance Neutral	Attendance Some Help	Attendance Very Helpful
Behavior - Conduct	Behavior - Conduct No Help	Behavior - Conduct Neutral	Behavior - Conduct Some Help	Behavior - Conduct Very Helpful
Behavior - Health and Wellness	Behavior - Health and Wellness No Help	Behavior - Health and Wellness Neutral	Behavior - Health and Wellness Some Help	Behavior - Health and Wellness Very Helpful
Parent Involvement	Parent Involvement No Help	Parent Involvement Neutral	Parent Involvement Some Help	Parent Involvement Very Helpful
Community/Volunteers	Community/Volunteers No Help	Community/Volunteers Neutral	Community/Volunteers Some Help	Community/Volunteers Very Helpful
Graduation	Graduation No Help	Graduation Neutral	Graduation Some Help	Graduation Very Helpful
Staying in School	Staying in School No Help	Staying in School Neutral	Staying in School Some Help	Staying in School Very Helpful
Social issues: food, clothing, and social services	Social issues: food, clothing, and social services No Help	Social issues: food, clothing, and social services Neutral	Social issues: food, clothing, and social services Some Help	Social issues: food, clothing, and social services Very Helpful

Additional Comments

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* 6. Are you satisfied with CIS services and resources CIS provides for the students you work with?

Yes

Other (please specify)

Communities In Schools Administration/Faculty/Partner Survey

CISGC Program Evaluation

Question Title

* 1. Full Name

Question Title

* 2. School/Organization

Question Title

* 3. Have you received information on CIS and implemented program services with the students you work with?

Question Title

* 4. Are you aware of the process to refer students to CIS? Do you have a referral process in place?

Question Title

* 5. Does CIS help students you work with in the following areas?

Question Title

* 6. Are you satisfied with CIS services and resources CIS provides for the students you work with?

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* 7. Are there any activities this year that you feel made a significant impact on your campus?

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* 8. Are there any additional activities you would like to see next year?

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* 9. Are there any additional services or improvements you would like to see CIS implement? Please specify...

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* 10. Are there any comments/suggestions you have regarding CIS staff and your interactions with them?

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* 11. Are there any comments/suggestions you have regarding CIS leadership and your interactions with them?