Monitoring and Evaluation (M&E) Data Collection Survey Form
Share structured information about activity implementation, progress, and lessons learned.
Project or activity name
*
Reporting date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Your role in the activity
*
Please Select
Project or program staff
Implementation partner
Community representative
Participant or service user
Other
How many people did the activity reach during this reporting period?
*
Overall, how would you rate the quality of implementation?
*
Very poor
1
2
3
4
Excellent
5
1 is Very poor, 5 is Excellent
To what extent are the planned results being achieved?
*
Not yet achieved
Partially achieved
Mostly achieved
Fully achieved
Too early to assess
How satisfied are participants with the activity?
*
Very dissatisfied
1
2
3
4
Very satisfied
5
1 is Very dissatisfied, 5 is Very satisfied
What were the main challenges during this reporting period?
What changes or recommendations would improve future implementation?
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