Form 1 AFI Capacity Building Visit Feedback Form

ASSETS FOR INDEPENDENCE CAPACITY BUILDING VISIT FEEDBACK FORM

INTRODUCTION

The purpose of this survey is to collect your feedback on the Capacity Building Visit you recently received for your Assets for Independence (AFI) project. We will use your feedback to improve our technical assistance (TA). We appreciate your candid feedback on this survey.

1. Organization: ______________________________

2. Date(s) of visit:

3. How would you rate the ability of the TA providers to listen and understand the needs of your AFI project?

   • Excellent

   • Good

   • Acceptable

   • Poor

   • N/A

4. How likely is it that the following capacity building visit activities will help you design a more client-centered project?

	Very unlikely	Unlikely	Likely	Very likely	N/A
Client Journey Mapping
Client Interview Process
Client Role Playing

5. How would you rate the ability of the TA providers to work with you to develop a capacity building plan that responds to each of the issues that emerged during the visit?

   • Excellent

   • Good

   • Acceptable

   • Poor

   • N/A

6. How would you rate the overall quality of services you received?

• Excellent

• Good

• Acceptable

• Poor

• N/A

7. What did you find most helpful about the capacity building visit? (open-ended)

8. If you could change one thing about the services you received, what would it be? (open-ended)

9. Please provide any additional comments. These comments will help ensure that AFI TA providers continue to improve services and meet the technical assistance needs of AFI grantees.

THE PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13)

Public reporting burden of this collection of information is estimated to average 0.25 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number.