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* Soror's Name:
   
 
 
 
* Initiation Date:
   
 
 
 
* Please provide the location of your initiation (i.e. chapter, school and/or city).
   
 
 
 
* Which is your age group?
 
20-25
 
26-35
 
36-46
 
47-57
 
58-69
 
70-80
 
81+
 
 
 
* Membership Status
 
Active
 
Life
 
Silver
 
Golden

 
 
 
Profession:
   
Title:
   
Duties/Responsibilities:
   
 
 
 
* Education--Degree(s) and Graduation Dates(s):
   
 
 
 
* What is your current educational status?
 
Recent College Graduate (with a year)
 
Graduate Student
 
Non-Student (not a recent graduate)
 
 
 
* 2012-2013 Conference Attendance:--Event Name and Date:
   
 
 
 
* Chapter Experience--Office(s) Held and Year:
   
* Committee Service and Year(s) (Please indicate if you were chair.):
   
 
 
 
* For historical purposes, please list your significant and/or innovative contributions that impacted chapter operations. For example, "as program chair, started the first Monday Activities." or "as Technology chair, created the first chapter list serve."
   
 
 
 
* Please list Alpha Kappa Alpha awards and recognitions (local, regional, or international) received from the Sorority. These would be individual or chapter awards received during times of service.
   
 
 
 
* Regional Experience--Office(s) Held and Year(s):
   
* Committee(s) Served and Year(s):
   
 
 
 
* National Experience--Office(s) Held and Year(s):
   
* Committee(s) Served and Year(s):
   
 
 
 
* Offices and/or Committees Ready to Serve Now:
   
* Offices and/or Committees Ready to Serve in 2 Years:
   
* Offices and/or Committees Ready to Serve in 4 Years:
   
 
 
 
Membership
 
 
 
* When did you join Xi Omega?
   
 
 
 
* How many years of membership do you have with the sorority?
 
0-5
 
6-10
 
11-15
 
16-24
 
25-49
 
50-60
 
61-72
 
72+
 
 
 
* How many years of continuous membership do you have with Xi Omega?
 
0-5
 
6-10
 
11-15
 
16-24
 
25-35
 
36-46
 
47-59
 
60-70
 
71+
 
 
 
* How were you initiated?
 
Undergraduate
 
Graduate
 
 
 
* Have you been active since initiation?
 
Yes
 
No
 
 
 
Chapter Involvement and Satisfaction
 
 
Conference Attendance in the last five years:
0 1 2 3 4 5 6
* Regionals
* Cluster
* Boule
* Leadership
* Round Up
* Chapter Retreat
 
 
 
* How satisfied are you with the chapter?
Very Unsatisfied
Unsatisfied
Neutral
Satisfied
Very Satisfied
 
 
 
* If you answered neutral, unsatisfied, or extremely unsatisfied please comment on why.
   
 
 
 
* Are you familiar with the National Program Platform?
 
Yes
 
No
 
 
 
* Do you feel Xi Omega is in line with the platform?
 
Yes
 
No
 
 
 
* Xi Omega effectively implements its annual programs through the delivery of service projects and activities.
Disagree
No really
Neutral
Yes
Absolutely!!
 
Please rate the following.
* How effectively has Xi Omega identified its service areas?
* I actively support and participate in Xi Omega's program planning process.
* Our program planning process is effective.
 
 
 
* Do you actively support Xi Omega service projects that carry out program platforms?
 
Yes
 
No
 
 
 
* If you do not support Xi Omega service projects, why not?
   
 
 
 
* Please provide some suggestions to help improve delivery of Xi Omega's program platform targeting service.
   
 
 
 
* Do you feel Xi Omega surveys are effective?
 
Yes
 
No
 
 
 
* What if anything would discourage you from completing a chapter survey?
   
 
 
Please rate your agreement with the following regarding Xi Omega surveys:
* I am confident Xi Omega makes significant changes based on survey results.
* Surveys are conducted in a timely manner after an event.
* Surveys are given at the appropriate time and place.
* Surveys are adequate related to the activity.
* The format is satisfactory.
* Xi Omega reaches a representative population for surveys based on membership.
 
 
 
* What format is the best to improve survey responses?
 
More online surveys
 
e-Stations at chapter meetings
 
Hard copies at events and meetings
 
Other
 
 
 
 
* Do you feel you understand the significance and value added of chapter surveys?
 
Yes
 
No
 
Maybe
 
 
Please rate your agreement with the following:
* Retreats and planning sessions are conducted in a timely manner for program planning.
* Chapter programs and activities are executed as expected and planned annually.
* The chapter budget and operations support planned programs.
* The chapter conducts business according to the International Bylaws, Chapter Bylaws and Manual of Standard Procedure.
 
 
 
Documents
 
 
 
* I have a current copy of my sorority documents.
 
Yes
 
No
 
 
 
* Are you aware of when the bylaws are to be reviewed and revised?
 
Yes
 
No
 
 
 
* Do you feel that YOU are an integral part of the review process?
 
Yes
 
No
 
 
 
* Do you believe the bylaws adequately address the functioning of Xi Omega?
 
Yes
 
No
 
I don't know.
 
 
Finance
 
 
 
* Based on current operations and dues, do chapter dues provide financial stability to the operations of the chapter?
 
Yes
 
No
 
I don't know.
 
 
 
* Does the chapter participate in annual financial planning for operations?
 
Yes
 
No
 
I don't know.
 
 
 
* Does the chapter participate in annual planning for investments?
 
Yes
 
No
 
I don't know.
 
 
 
* Annual charitable contributions and scholarships are representative of the chapter size.
Disagree
Doubtful
Neutral
Yes
Absolutely!
 
 
Please rate your agreement with the following comments:
* The chapter provides accurate and up to date financial statements/activity costs to members.
* The Foundation assessment is sufficient for community contributions based on chapter size.
* The chapter should pay full conference registration fees for conference delegates.
* Dues are adequate to address the needs of the chapter.
 
 
 
Investments
 
 
Please rate your agreement with the following statements:
* Xi Omega should delegate long-term financial investments to a separate committee.
* Interest earnings should be part of the budget projections each year.
* Xi Omega should explore alternative investment vehicles to maximize returns.
* Xi Omega should have specific plans/bylaws governing the allocation of operational overages.
* Decisions on investing chapter money should be delegated to a Finance Committee.
 
 
 
Technology
 
 
 
* Have you visited the chapter's website?
 
Yes
 
No
 
 
 
* How often do you visit the site?
 
Once a week
 
More than once a week
 
Once a month
 
More than once a month
 
Occasionally throughout the year
 
Never or almost never
 
 
 
* Are you registered on Big Tent?
 
Yes
 
No
 
I don't know.
 
 
 
* Do you feel the website and Big Tent are kept current?
 
Yes
 
No
 
I don't know.
 
 
 
* Are the sites user-friendly?
 
Yes
 
No
 
I don't know.
 
 
 
* What technology improvements would you like to see?
   
 
 
 
* Do you feel the site content is kept relevant and pertinent to the chapter and our members?
 
Yes
 
No
 
I don't know.
 
 
 
Undergraduate Relations
 
 
 
* Do you know the names of the undergraduate chapters for which Xi Omega serves as the graduate sponsor?
 
Yes
 
No
 
 
 
* Are you currently certified as a graduate advisor?
 
Yes
 
No
 
 
 
* Do you plan to take the Graduate Advisor's Certification?
 
Yes
 
No
 
 
 
* Have you ever volunteered your professional expertise with the undergraduate chapters, such as providing a workshop?
 
Yes
 
No
 
 
 
* Have you attended a joint chapter meeting with Xi Omega and its affiliated undergraduate chapters?
 
Yes
 
No
 
 
 
* Do you feel you are well informed about the activities of the undergraduate chapters?
 
Yes
 
No
 
 
 
* Do you think mentor-mentee programs have been effective?
 
Yes
 
No
 
I don't know.
 
 
 
Connections
 
 
 
* Xi Omega is adequately informed through the Connections committee about local, regional, national and international political issues.
Strongly Disagree
Disagree
Neutral
Agree
Agree Strongly
 
 
Please rate your level of agreement with the following:
* Xi Omega designs strategies for communication with members on political issues.
* Xi Omega mobilizes members for action on political issues.
* Xi Omega has given me details about candidates and issues for informed election choices.
 
 
 
Final Thoughts
 
 
 
Please provide any remaining comments you feel are appropriate to share and thank you for participating in keeping this chapter grand!