Winners’ Circle Pre-workshop Assessment Survey

Your response to this survey will aid in the planning of the workshop so it can best address your
specific needs and desires. Your responses are strictly confidential and will NOT be shared
with your coworkers or management. Please be honest and feel free to elaborate on an
additional sheet. Please return this form to Bella Terra (email to staff@bellaterrainc.org or fax
at # 269-668-7289) no later than 5 days prior to your scheduled workshop.

Name: Date:

Organization: Position:

1. Have you ever been a part of an 'adventure-based' experience before?

If yes, where? when? what type? Was it a positive experience for you?

2. What do you like MOST about your current position?

3. What do you like LEAST about your current position?

4. What do you see as the primary purpose of your team within your organization?

5. How effective are you and the team in meeting this goal or achieving this purpose?

6. Even the most effective teams have room for improvement. What does your team need to
improve its performance/effectiveness? What resources would aid this improvement?

7. On a scale of 1 to 10 (with 1 being not effective at all and 10 being almost perfect), where
would you place the communication between management and staff?
Why did you give it this rating?

8. On a scale of 1 to 10 (with 1 being not effective at all and 10 being almost perfect), where
would you place the communication between staff members?
Why did you give it this rating?

9. Please set a goal for your workshop experience: