Qualtrics Survey | Qualtrics Experience Management

Please describe the community engaged partnership that your department/unit would like to submit for the "Community Engagement Showcase" event:

Your Name

Your Email

Project/Collaboration Title

Community Partner name and email contact

Purpose of this collaboration

Length of partnership

Number of faculty involved

Number of students involved

Number of staff involved

Grant funding, if relevant

Impact on the institution

Impact on the community

To what extent do you agree or disagree with the following statements with regards to your partnership?

To what extent do you agree or disagree with the following statements with regards to your partnership?
	Strongly disagree	Disagree	Neither agree or disagree	Agree	Strongly agree
Community partners are recognized by the campus.	Strongly disagree	Disagree	Neither agree or disagree	Agree	Strongly agree
Community partners are asked about their perceptions of the institution’s engagement with and impact on community.	Strongly disagree	Disagree	Neither agree or disagree	Agree	Strongly agree
The community partners’ voice is heard and they have a seat at the table in important conversations that impact the community.	Strongly disagree	Disagree	Neither agree or disagree	Agree	Strongly agree
The faculty and/or staff that work with the community partnership take specific actions to ensure mutuality and reciprocity in partnerships.	Strongly disagree	Disagree	Neither agree or disagree	Agree	Strongly agree
The campus collects and shares feedback and assessment findings regarding partnerships, reciprocity, and mutual benefit, both from community partners to the institution and from the institution to the community.	Strongly disagree	Disagree	Neither agree or disagree	Agree	Strongly agree
The partnership has had a positive impact on the community.	Strongly disagree	Disagree	Neither agree or disagree	Agree	Strongly agree

Describe the actions and strategies used by the campus to ensure mutuality and reciprocity in this partnership.

Please provide any additional information that you think will be important for understanding how the campus partnering with the community has enacted reciprocity, mutual respect, shared authority, and co-creation of goals and outcomes.