Title of Initiative Or Activity Or Elements This Survey Asks About, with Dates of Activities

Title of Initiative Or Activity Or Elements This Survey Asks About, with Dates of Activities

Title of Initiative or Activity or Elements This Survey Asks about, with Dates of Activities or Initiative

Follow-Up Survey

Thank you for participating in the activity mentioned above.

We would like to learn about the results of this activity from your viewpoint. We would also like to know your suggestions for improvement. For both of these reasons, we would be very grateful for your responses to the questions on the next pages. Your opinions are very valuable to us.

Note that your responses may be shared in WBI's reports to its stakeholders, which may be public. Your response to this questionnaire constitutes your agreement that WBI may use the information for this purpose.

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  1. What is your:
  1. First/given name
  1. Last/family name
  1. Organization (full name)
  1. Organization (acronym)
  1. Title within the organization

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Your actions

  1. Have you done anything new or different because of the activity above or partly because of the activity above?

(Consider actions you have taken alone or together with others.)

 Yes No (skip to “Barriers” question) Can't recall (skip to “Your Advice” question)

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Your actions

  1. Which of the following areas relate to the new or different actions taken? (Select all that apply)

 the way you work

 the way an organization or group with whom you are affiliated works

 a project or program at a subnational level (community, city, province, state, etc.)

 a project or program at a national level

 a project or program at an international level

 a policy, strategy, or law at a subnational level (community, city, province, state, etc.)

 a policy, strategy, or law at a national level

 a policy, strategy, or law at an international level

 Other (please specify)______

  1. Please tell us about these actions.

What have you done, alone or with others, that is new or different?

Below, describe the actions taken and how they differ from before your participation in the activity above.

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Consequences of your actions

  1. What (if anything) has happened as a consequence of these actions?

If these actions affected an organization, project, or policy, give the name of the organization, project or policy, and describe how it was affected.

As relevant, specify:

(a) what changed (i.e. from what previous status to what new status),

(b) the approximate number and general profile of people affected, and

(c) what was the effect on these people.

  1. In which country (or countries) do you expect that any consequences of these actions could be seen?

______

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How the activity helped

  1. How did the activity above contribute to the actions and/or consequences you described?

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Barriers

  1. What factor(s) limited your ability to do anything new or different following your participation in the activity above? (If response to “Your actions” [question 2] above was “Yes”, skip to “Your Advice”.)

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Your advice

  1. In retrospect,

what advice can you give us to improve the value of our activities in the future?

To submit your response, click "Done" below.

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Your response was received.

Thank you for your time and attention to this questionnaire.

Follow-UpSurvey.docx, page 1 of 4

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