Outreach Needs Assessment Form

Needs Assessment Form

To be filled by the Connection Group leader leading the outreach activity
This form will help the Outreach administration team have some background on the choice of community you seek to reach out to and support you in monitoring and measuring your success.

In case you have any challenges, do not hesitate to contact the Outreach Department by sending an email to outreach@mlfc.org.
Which Connection Group do you belong to?*
Name of Connection Group Leader*

First NameLast Name
Connection Group Leader's Phone Number*

Area CodePhone Number
Connection Group Leader's Email Address*
Name of Organisation*
Name of Contact Person*

First NameLast Name
Contact Person's Phone Number*

Area CodePhone Number
Contact Person's Email Address*
example@example.com
Location of Organisation*
Brief description of Organisation*
How many people are you planning to reach out to?*
What are the spiritual needs of this community?*
What are the physical needs of this community?*
How many times in a year do you plan to monitor the progress of your intervention?*

WeeklyMonthlyQuarterlyYearlyOther
What support do you need from the church?*
What COVID-19 prevention measures will you put in place?*
When do you intend to conduct the activity?*

DayMonthYear
DateHourMinutes
Upload your outreach program (this should include the activity you are plan to do and who will be responsible)*

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Upload your 3 quotes here (include their respective bank details)

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