Needs Questionaire

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Identifying Needs Questionaire

Rotary Clubs should consider the needs that exist within their immediate area. An assessment should then be made to determine which will be addressed locally and which require outside assistance.

The checklist can be used to identify if a need exists in each issue listed with either a ‘yes’ or ‘no’

Any listed issues with a ‘yes’ should then be further identified with a ‘yes’ or a ‘no’ to signify if outside assistance would be appreciated. Clubs may also wish to identify the nature of assistance required in the second part of the survey.

Any clubs willing to provide assistance can view these surveys once returned, to ascertain where they may put their efforts. These clubs will then make direct contact with the Rotary Club that identified the need.

Name of submitter:

Your email address:

Select your club - Rotary Club of:

Please indicate areas of local issues of concern

Identfied?

Outside Help Needed?

Drought::

Yes

Fire::

Yes

Resources::

Yes

Animals::

Yes

Plants::

Yes

Wildlife::

Yes

Water::

Yes

Water Storage::

Yes

Feed::

Yes

Feed Storage::

Yes

Seed for Planting::

Yes

Fertilizer::

Yes

Cleanup after fire::

Yes

Fencing::

Yes

Erosion control::

Yes

Children::

Yes

Women::

Yes

Men::

Yes

Families::

Yes

Schooling::

Yes

Transport::

Yes

A break away from home::

Yes

School Camps::

Yes

Local Infrastructure::

Yes

Transport::

Yes

Home repairs::

Yes

Fuel::

Yes

Wood for winter::

Yes

Food Hampers::

Yes

Basic necessity Hampers::

Yes

Describe any
other problems ::

What is requested

Types of assistance

Identfied?

Outside Help Needed?

Someone to talk with:

Yes

Assistance with Grants:

Yes

Advice:

Yes

Organising ability:

Yes

Communication:

Yes

Gatherings:

Yes

Holidays away:

Yes

Funding:

Yes

Materials:

Yes

Labour:

Yes

Visits by understanding outsiders:

Yes

Support for local commerce:

Yes

Stock Agistment:

Yes

Entertainment:

Yes

Shared Meals:

Yes

Concerts:

Yes

Fencing Materials:

Yes

Fodder:

Yes

Seed :

Yes

Fertilizer:

Yes

Funding school camps:

Yes

Money via District Committee:

Yes

Comments Box:

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Last modified: 2 Apr 2012 00:06