Community Service

Part I

1. What areas are you aware of that needs a new breath of life to energize you?


2. What area of your life do you want to grow?


3. What problems are associated with the reason you have not grown in that area?


4. Are you aware of actions that may be taken to increase your ability to achieve
your success in that area?


5. Do you possess the information, knowledge, and skills necessary to achieve your
goal? Comments:

Part II

1. What factors, if any, inhibit you from reaching your full potential and/or success?


2. What would you like to see happen that would improve your ability to succeed and what are some steps you would take to complete this process?


3. Which of these action plans do you plan to carry out first and what are your expected outcomes from these plans?


4. How will you evaluate your success? Describe the barriers to the success and if they can be removed?


5. What additional support could assist you in implementing your action plans?



Beyond the action plans that you identified:

6. What additional activities might increase the opportunity for your success?


7. Have you put together a business plan for your endeavors or goals? If not, would you like assistance putting one together?



Part III

1. What type of workshops are you interested in and are willing to attend?


2. Would you be interested in participating in an online social network with diverse women with similar interests? Comment:


3. Is it important to you that the presenter of information be well-informed on the subject? Comment:


4. Is it important to you that the presenter of information be able to effectively          communicate information to the audience? Comment:


5. Is it important that you receive handouts for the session?


6. What type of content will be useful in helping you achieve your goal?



Part IV General Questionnaire (Optional)

Choose one of the following for each question:

Race:

• African American
• Caucasian
• Asian
• American Indian
• Hispanic

Gender:

• Female                                                        
• Male

Age Range:

• 17 and under
• 18-25
• 25-35
• 35-45
• 45+

Education:

• Less than high school
• High school
• Some college
• Professional

Income:

• Less than $30,000
• $30,000-$40,000
• $40,000-$50,000
• $50,000 and above