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Section 5. Constituent Survey of Outcomes: Ratings of Importance

Tool 1: Cover Letter for Constituent Survey of Outcomes

This is a good beginning to your survey, it informs the person filling it out what your intentions are.

Cover Letter for Constituent Survey of Outcomes



Dear Members of (the initiative):

The purpose of the attached outcome survey is to get your feedback on how (the initiative) is doing. As you know, the mission of (the initiative) is to ________________________________ in ____________________________________ (city / county).

Please complete each question by circling the number that illustrates how important each community change is to the mission of (the initiative).

To protect anonymity, please use the enclosed self-addressed envelope and return your completed survey to our evaluators, the (name them).

Thanks in advance for your valuable advice and feedback.


Best regards,


Executive Director


Tool 2: Sample Outcome Survey

This survey template can give you an idea of how to set up your own.

                                                             Outcome Survey

Please return by:

Staff and members of (the initiative) have been involved in efforts that resulted in a variety of community changes related to the mission of _________________.

This survey lists (#) community changes that resulted from the initiative's efforts. For each survey item, please circle the number that best describes how important each community change is to the initiative's mission of ______________________. Use the following scale to rate your answers.

Community Changes Date Accomplished Very Unimportant Unimportant Neutral Important Very Important



  1 2 3 4 5



  1 2 3 4 5



  1 2 3 4 5

Taken together, how important are the above community changes in accomplishing the mission of (the organization)?

  1 2 3 4 5