Sample Living Well Month Survey

Perhaps you can use this type of survey in your state to see how everyone in Extension used the Living Well Marketing Materials for National Extension Living Well Month.Illinois has used this survey for several years.

Living Well Month Surveyfrom ______County, ____ or ______Center

Thank you for promoting and celebrating the national “Extension Living Well Month”during March. A national survey of several hundred people, conducted a some years ago, revealed that many people from the public are not aware of the family and consumer sciences programs and resources that Extension has for families. Living Well marketing materials and Extension Living Well Month were created especially to help the public become aware of the valuable programs and resources that Extension has at the local level to help families in raising kids, eating right, spending smart and living well.(The Living Well marketing materials are valued at over $150,000, and were paid for by the National Extension Association of Family and Consumer Sciences.)

Please complete the survey (on the next page) to indicate what you or your staff did for “Extension Living Well Month”. You can do one form for the whole office or each person can submit the completed survey.

Place a check mark or fill in the blanks that apply to materials used or things that were done in celebration or promotion of Extension Living Well Month. The information will be reported in order to receive the last half of the money for an NEAFCSLiving Well mini-grant of $500 that wasreceived.The money was used to: ______(make Living Well calendars for all Extension council members in the state, posters and displays for each Extension County Unit Office in the state and all NEAFCS members in the state.)

Return the survey to (name)______@(email:______when you have finished promoting Extension Living Well Month. Or you can fax the survey to (name)

at ____(Fax number)_at the ______ExtensionCenter.

Do you have comments or suggestions to consider for the 2010 Extension Living Well Month?

Please list them here:

Thank you completing the survey. We appreciate your help in marketing Extension’s Family and Consumer Sciences programs to the public.

(name)______

University

Phone:

email:

FAX:

What We Did for Extension Living Well Month
March ______/ Mark your responses in this column:
1. Used the Living Well slogan on my email signature:
(Raising kids, eating right, spending smart, living well) / . ______Yes
2. Had family and consumer sciences program(s) during Extension Living Well Month.(such as family life, nutrition, wellness, FNP, EPNEP, or consumer-related programs) / How many programs? ______
3. Invited a Congressman or Legislator to attend one of our family and consumer sciences programs during Living Well Month. / ______Yes.
  1. Used the Extension Living Well Month Proclamation or Resolution (from the internal Living Well Website)
(Such as by the Mayor or County Board President or CountyCommissioner) / From a city official ______
or a county official ______
  1. Used Living Well promotional materials from the internal website:
Materials Used Include:(check the ones used)
____Living Well PowerPoint slides
____Living Well Print ads
____Living Well Logos
____Living Well Tagline
____Living Well Bookmarks…………………………………..
____Cereal Bars Wrappers………………………………………
____Living Well News Releases ………………………………..
____Living Well PSAs in English………………………………
____Living Well PSA’s in Spanish……………………………..
____6. Shared the Living Well website: or Extension website with public:
Which ways did you share this website: _____ Extension flyers, _____ publications, _____ news releases _____ in my email signature, _____ other: ______/ ______Yes
How many bookmarks? _____
How many cereal bar wrappers?____
To how many media sources: _____
To how many media sources: _____
To how many media sources: _____
_______Yes
  1. Used the Living Well poster or Living Well brochure in a display or posted/distributed it in a public place
/ Poster ______Yes
Brochure______Yes
  1. Used the Living Well banner display
(contact ______to borrow it) / ______Yes
9. Used the template: Helping Families in Your District to Put Knowledge to Work (from the internal Living Well website) / ______Yes
10. Did TV or radio program about Extension Living Well Month. / _____How many radio programs?
_____How many TV programs?
Return completed survey to: ______
Or fax to: ______Thank you. / From ______unit/center