Community Assets Inventory

Introduction:  I am from (name of church) and we are trying to work together with members of our neighborhood to make our community better.  To do this, we are trying to put together a listing of all the skills and talents that people have.  This survey takes (amount of time). Would you be willing to participate?

Interviewer Name: ______________________________________________

Community Member Name: _______________________________________

Address: ______________________________________________________

Home Zip Code: ________________________________________________

Are you familiar with (name of church)? YES   NO

(If they are not familiar, tell them the address and the mission statement.)

What do you see as the major issues that our neighborhood faces?

Could you see yourself working with others on these issues? YES   NO

Who else would be good to work on these issues?

What are three or four things that you know well enough and would be willing to teach others?

What are three or four things you would like to learn?

Are there any additional comments or suggestions you would like to make?

Thank you very much for your time.