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SOU Constituent Survey - Q1/2011

Thank you for agreeing to participate in our survey.  All responses will be kept strictly confidential.  

Established in 2003, Step Out USA is a not-for-profit organization creating social, cultural, recreational and educational connections for adults with learning disabilities.  Our long-term objectives are to reach a broader audience; be more responsive to our constituents; and provide services in a more effective manner. 

Your input will help our organization to accomplish these goals.

 
1.

Please provide current contact information so that we may update our records.


First Name:
Last Name:
Company Name:
Work Phone:
Home Phone:
Email Address:
emailaddress@xyz.com
Address 1:
Address 2:
City:
State/Province
(US/Canada):
Postal Code:

2.

Respondent Profile

Please describe the nature of your involvement with, or interest in, Step Out by checking all that apply.  "I am..."

The parent of an LD adult
The sibling of an LD adult
Another relative of an LD adult
The employer of an LD adult
A health care professional
An education professional
A provider of support or services to the LD community
Other  
3.

When did you first become aware of the existence of Step Out?

2003
2004
2005
2006
2007
2008
2009
2010
2011
4.

Which of the following Step Out events/activities have you attended?  Please check all that apply.

Parent / Professional meetings
"Culture Vultures" outings
"Flick Friends" outings
Monthly social events
Educational seminars for members
SOU Board / Advsory Board meetings
Anniversary party
Holiday party
None of the above
5.

If you have attended Step Out Parent / Professional meetings, please rate the items listed below.

 Excellent Very Good Satisfactory Fair Poor 
Effectiveness of advance communication
Convenience of location
Suitability of venue
Suitability of date and time
Quality of food service
Price of food service
Quality of meeting content
Quality of guest speaker(s)
Overall value of participating
  • Comment:

  • 500 characters left.
6.

How do you typically receive information from / about Step Out?  Please check all that apply.

I receive the periodic newsletter; "INSTEP"
I visit stepoutusa.org online
I contact the Step Out professional staff by phone
I contact the Step Out professional staff by email
None of the above
Other  
7.

Based on your experience, please rate each of the items listed below.

 Excellent Very Good Satisfactory Fair Poor N/A 
"INSTEP" newsleter
"stepoutusa.org" website
Interaction with professional staff by phone
Interaction with professional staff by email
  • Comment:

  • 500 characters left.
8.

With respect to the adult LD community in general, please rate the importance of each of the items listed below.

 Critical Very important Moderately important Less important  
Continuing education for LD adults  
Socialization and recreational opportunities for LD adults  
Employment opportunities for LD adults  
Counseling services for LD adults  
Housing for LD adults  
Financial management / estate planning for families and care givers  
Education, support and resources for families and care givers  
Forums for interaction and networking among family members and caregivers  
  • Comment:

  • 500 characters left.
9.

Step Out USA is a volunteer-led organization with an important mission, but very limited resources.  Might you, or someone you know, be interested in helping out with occasional projects or activities?

Be sure that you entered your contact information above.

Yes, please contact me to discuss opportunities
No, sorry
10.

Step Out USA is seeking qualified and motivated individuals to join our Board or Advisory Board and help advance the organization's agenda.

If you have (or someone you know has) experience in non-profit administration, marketing and communication, fundraising, LD clinical services, and/or event management, please check the appropriate box below.

Be sure that you entered your contact information above.

Yes, please contact me to discuss further
No, sorry
11.

To help us reduce expenses and be kinder to the environment, may we send future editions of INSTEP to you via email?

Be sure that you entered your contact information above.

Yes, please send newsletters via email
No thanks, I prefer to receive newsletters via regular mail
12.

Please feel free to share any other comments, questions or suggestions.

 

350 characters left.

Thanks again for your time and input.  When you click "finish" you'll be redirected  to the Step Out USA home page.  Have a great day!