Form HUD xxxx HUD xxxx 2014 Poll Questions

Generic Customer Satisfaction Surveys

2014 Poll Questions-9-5

Fathers Day

OMB: 2535-0116

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Paperwork Reduction Act Notice. Public reporting burden for this collection of information is estimated to be 1 hour per PHA, and includes time for reviewing the instructions, and completing and reviewing the responses. Your completion of this information collection is voluntary. HUD may not collect this information, and you are not required to complete this form, unless it displays a current, valid OMB control number.

Instructions: Upon completion of your event, PHAs are strongly encouraged to complete this evaluation form electronically by clicking on the link you were sent once your Father’s Day event was held. Please mark the response below that best describes your assessment of the event. HUD will use this information to determine the success, nationwide, of Father’s Day events.


Father's Day 2014

Name of PHA:






Shape1

Please mark the objectives that apply to your event:

Increased bond between fathers and children

Increased access by fathers to resources

Strengthened families/communities

Other (please specify):


If yes, please mark the objectives that


Did you encounter any of the following obstacles:
Lack of funding

Lack of staffing

Lack of community support

Lack of impact

Low attendance

Other (please specify)



What would have enhanced your Father's Day event (check all that apply)?

Assistance in finding federal partners
More time to plan
More PHA sharing of ideas
More webcasts
Other (please specify)

Number of event sites hosted


Number of participating fathers


Number of participating children


Number of other attendees









Please indicate which partners supported your event(s)

Federal agency (please specify):

Department of Labor - Workforce Investment Board/One Stop

Department of Health & Human Services – Agency for Children and Families

National Fatherhood Initiative
Faith-based Organizations
Boys and Girls Clubs of America

State agency (please specify):

Police, Fire or Emergency Responders

Park or Recreation agency

Historically Black Colleges/Universities
Fraternities and Sororities (please specify)
Other (please specify):


Shape2

What types of activities or resources were available at your event?


Health services (please specify)
Childcare
Youth Services
Parenting/life skills training
Legal services
Employment or job training
Educational institutions
Mental health/substance abuse organizations
Sport celebrity or organization
Other (please specify)


Will you sponsor any other father-related activities during the year? Yes No


If yes, please identify the focus of the activity:


Education

Community Service

Health

Sports

Legal

Employment

Other:












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