| MY FORUM ROLE |
| My role with this Forum group is: |
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| GROUP CHARACTERISTICS |
| 1. How many members are in the Forum group today? |
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| 2. How many female members are in the Forum? |
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| 3. How many years ago was this Forum started? |
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4. How long ago did you join this Forum?
(skip this question if not a member) |
Years |
| 5. What is the age range of the Forum members? |
Youngest: |
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| Oldest: |
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Avg. Age:
(best guess) |
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| 6. How many members of the Forum are Forum trained? |
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| TRAINING |
| 1. Which of the following training programs have you attended? |
* Forum Workshops were previously called Advanced Forum Series (AFS) |
| 2. About how many years ago was your last training? |
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| RETREAT |
| 1. How many years ago was the last Forum Retreat? |
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| a. Did that retreat have an outside Facilitator? |
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| b. Was there 100% attendance at that retreat? |
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| MY FORUM |
| Forum: |
(The Forum name) |
| Forum Type: |
(The type of Forum) |
| Survey Champion Name: |
(Your name) |
| Email Address: |
(Your Internet email address) |
| Region: |
(The Region name) |
| Chapter: |
(The Chapter name)
(If Chapter does not appear, enter here) |
Member Email Addresses:
(Email addresses of Forum members. These are necessary to send a link for the survey. Please use the e-mail address each member uses for Forum matters. Press the Enter key after entering each address)
Example:
[email protected]
[email protected]
[email protected] |
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| Survey Champion Password: |
(Create a password that you will use to view the results fo the survey) |
| Member Password: |
(Create a password that will allow all other members to take the survey. This password MUST BE IN ALL CAPS and should be something simple to use and key in) |
| Survey End Date: |
/
/
(The survey ends on this date) |
(You can edit or replace the standard email subject line for member notifications) |
| Message from Survey Champion |
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(This message will be included in the email that is sent to the individuals in the Member Email Addresses field) |
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| Rating Questions (Note to Survey Champion: questions 1-22 are shown as they will appear in the survey. The questions below are not a live survey and are shown for illustration only. Please review and scroll down to questions 23-25, which you may customize for your Forum). |
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| MEETING PROCESS |
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| 1. ATTENDANCE |
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1= |
Members are frequently absent with no consistent group at our Forum meetings |
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10= |
Our Forum meetings have 100% attendance except for unique, infrequent scheduling conflicts |
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| 2. PUNCTUALITY |
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1= |
Forum meetings do not start or end on time |
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10= |
Forum meetings start and stop on schedule; there is almost no wasted meeting time |
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| 3. FORUM CONSTITUTION |
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1= |
We have no written constitution or consistent adherence to ground rules governing operations of the Forum (for example: attendance, punctuality, use of cell phones/PDAs, 5% Reflection process) |
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10= |
We have a written constitution, it is referred to when addressing difficult Forum issues and reviewed annually |
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| 4. 5% REFLECTION: Depth and Structure |
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1= |
Members share superficial information in their 5% Reflections; they do not share the significance or feelings associated with the events of the last month. 5% Reflections are also unstructured, run overtime and involve lots of dialogue with the rest of the group |
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10= |
Members only share the most important events of the last month, including their significance and associated emotions. Everyone has a prepared 5% Reflection, presents within 3-5 minutes, with no interruptions. |
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| 5. COACHING: Preparation |
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1= |
We do not consistently choose coaches to assist presenters or have face-to-face coaching sessions before meetings |
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10= |
All planned Deep Dives are coached in person prior to the meeting, unplanned Deep Dives include a brief coaching session during a break in the meeting before presenting |
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| 6. DEEP DIVES: Consistency |
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1= |
In our Forum meetings, Deep Dives are rare or ill prepared |
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10= |
Forum meetings are built around well prepared Deep Dives: All members present regularly and with appropriate topics; strict protocols and time limits are always followed |
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| 7. DEEP DIVES: Listening |
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1= |
Our Forum members hear the ‘facts’ of the Deep Dive, driven by a problem solving mind set (“If I just knew a few more things I could come up with a great suggestion.”) |
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10= |
Our Forum listens for the emotional level of the Deep Dive and hears the inner struggle; we use this understanding as way to select relevant past experience |
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| 8. DEEP DIVES: Q & A Section |
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1= |
We often interrogate our presenters, sometimes with disguised advice, for over 10 minutes, sometimes as long as 30-40 minutes |
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10= |
We ask very few questions, spending 5 – 10 minutes or less, ONLY asking questions to determine which experiences would be most appropriate to share |
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| 9. DEEP DIVES: Speaking from Experience |
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1= |
Our Forum members give each other direct problem solving answers (ideas, opinions, analysis, recommendations), and advice |
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10= |
We share specific details of past experiences – negative and positive - and our feelings and impacts from those events |
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| STRENGTH OF FORUM RELATIONSHIPS |
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| 10. KNOWLEDGE/UNDERSTANDING OF OTHER MEMBERS |
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1= |
I have little understanding of the background or motivations of many of my Forum members |
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10= |
I understand the history and motivation of each member of my Forum |
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| 11. MEETING DEPTH |
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1= |
Our meetings are ‘Show & Tell’, ‘Nuts & Bolts’ style with no real depth |
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10= |
Significant unresolved issues are consistently raised in our meetings requiring meaningful input and thought |
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| 12. FORUM OPENNESS |
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1= |
Delicate issues are skirted or avoided in Forum |
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10= |
We are open and honest about all issues in Forum |
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| 13. FORUM MINDSET |
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1= |
Members of my forum are often harsh and judgmental with each other |
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10= |
Our Forum is understanding and empathic; we can listen to each other’s difficulties without judging or needing to ‘fix’ |
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| FORUM MEMBERSHIP |
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| 14. MEMBERSHIP CONTINUITY |
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1= |
There is too much turnover in our Forum (revolving door) and/or members who should leave but will not (e.g. no longer qualify or non-members of EO) |
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10= |
Our Forum membership is stable, without feeling stagnant |
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| 15. CONFLICTS OF INTEREST |
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1= |
There are conflicting interests in my Forum that limit openness or topics discussed |
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10= |
We have no significant business or personal conflicts, all topics can be discussed |
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| INDIVIDUAL PARTICIPATION |
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| 16. CONFIDENTIALITY |
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1= |
I will not divulge confidential matters in Forum for fear of leaks |
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10= |
I feel all matters discussed will be held in strict Forum confidence by all members |
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| 17. TRUST |
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1= |
I feel uncomfortable disclosing too much or taking risks with the group |
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10= |
I can comfortably discuss the most personal or risky issues in Forum |
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| 18. MEETING PARTICIPATION |
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1= |
There are a few members that dominate and others that say very little |
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10= |
We all participate equally and comfortably in Forum meetings |
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| 19. MY FORUM MEETS MY NEEDS |
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1= |
My Forum experience needs to change soon or I will leave this Forum |
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10= |
My Forum is a very meaningful and important part of my life |
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| LEADERSHIP |
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| 20. MODERATOR - LEADERSHIP & ORGANIZATION |
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1= |
Our Moderator very seldom seeks group input on direction; is laissez faire or totally dominates the meetings |
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10= |
Our Moderator balances seeking consensus for direction and encouraging everyone’s participation with a willingness to take the reins and keep us on track and moving forward |
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| 21. MODERATOR - SENSITIVITY |
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1= |
Our Moderator very seldom reads the mood or feelings of the members or the group |
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10= |
Our Moderator appears to be very aware of the mood of individuals and group, and intervenes to focus, redirect, change the pace, probe or draw out members as appropriate |
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| RETREATS |
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| 22. OUR FORUM RETREATS |
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1= |
Our retreats are superficial, purely social or a waste of time |
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10= |
Our retreats involve very meaningful interaction, strong bonding of members, fun and are ‘not to be missed’ events |
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25.
Optional opened ended question. |
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