USDA Forest Service
OMB 0596-NEW
EXP. XX/XX/201X
[FULL VERSION]
Welcome to the STEW-MAP survey!
Burden Statement
PAPERWORK REDUCTION and PRIVACY ACT STATEMENTS: According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a valid OMB control number. Response to this request is voluntary. No action may be taken against for refusing to supply the information requested. The permanent data will be anonymous.
BURDEN ESTIMATE STATEMENT: Public reporting burden for this form is estimated to be 30 minutes per completed response. Direct comments regarding the burden estimate or any other aspect of this form to: Survey contact Name, full address and email address.
The U.S. Department of Agriculture (USDA) prohibits discrimination in all its programs and activities on the basis of race, color, national origin, gender, religion, age, disability, political beliefs, sexual orientation, and marital or family status. (Not all prohibited bases apply to all programs.) Persons with disabilities who require alternative means for communication of program information (Braille, large print, audiotape, etc.) should contact USDA’s TARGET Center at 202-720-2600 (voice and TDD).
To file a complaint of discrimination, write USDA, Director, Office of Civil Rights, 1400 Independence Avenue, SW, Washington, DC 20250-9410 or call (800) 795-3272 (voice) or (202) 720-6382 (TDD). USDA is an equal opportunity provider and employer.
The Stewardship Mapping and Assessment Project or STEW-MAP is collecting information about civic groups and organizations that do environmental stewardship work in your region.
STEW-MAP uses the following definition of stewardship:
Stewardship is conserving, managing, caring for, monitoring, advocating for, and educating the public about local environments. This may include planting trees, restoring a prairie, advocating for open space preservation, gardening in a schoolyard, cleaning up a vacant lot, or many other kinds of activities.
By completing this survey, you will be helping potential volunteers, public agencies, funders, and other stewards find your group and learn about what it does. You will also be able to learn about other stewardship groups in your region.
Your participation is completely voluntary. Your personal contact information will not be made public or used for any other purposes than by the research team to contact you if there are any questions about information you provide on the survey.
If you wish to have your organization’s basic contact information and the place(s) you work displayed on the stewardship map for the region, you will have an opportunity to let us know in section two of this survey. All of the information you provide will help us to visually display the network of stewardship activities in your region.
Please use the following URL to start the survey.
SURVEY URL Here
However, if you would prefer paper version or to complete the survey over the telephone, please contact XXX.
STEW-MAP projects have already been done in Baltimore, Chicago, New York City, Philadelphia, and Seattle. Please visit www.stewmap.net to learn more.
Thank you for your time and participation!
STEW-MAP Survey
Section 1: Contact information
Your personal information will remain anonymous and we will not share the identifying information below with anyone outside of the research team. We may contact you if we have questions about information you provide on this survey.
Your Name:
Your Phone Number: ( _) -
Your E-mail:
Section 2: Contact Information for your group or organization
If you are affiliated with more than one group or organization (from now on, we’ll just say “group” to keep things simple), please fill out the survey for each one. If you are not able to answer all of the questions, please reach out to someone else in your group and ask them to fill out the survey.
Group Name: (required)
Website (if available):
Mailing Address: (with city/state/zip)
Group E-mail:
Group Phone Number: ( ) -
Does your group wish to be on the online stewardship map?
The information associated with your group on the map will be limited to group name, website, mailing address, group email, and group phone number – plus your stewardship territory, which will be addressed later in the survey.
Yes
No
Section 3: General stewardship activities
Does your group do any of the following? Please select all that apply.
Conserve or preserve the local environment?
Take care of a place in the local environment (for example, a community garden, a block of street trees, an empty lot, a riverbank, a schoolyard, a forest preserve)?
Restore or transform local habitat (e.g., daylighting a stream, brownfield to prairie restorations)?
Monitor the quality of the local environment? This can include monitoring air or water quality, dumping, or species monitoring.
Advocate for the local environment?
Educate the public about the local environment?
[In the electronic version of the survey, if none of the above are selected, a pop-up appears that says “Thank you for your interest in filling out this survey. Your group's work does not meet our definition of environmental stewardship so we have no further questions. If you feel you have gotten this in error, please go back to the survey and continue.”]
Section 4: Basic information about your group
Please choose the most appropriate response.
501(c)(3) (or has applied)
501 (c)(4) (or has applied)
Community group without 501(c)(3) or 501(c)(4) status (for example, a community garden group or block club)
Local government agency
State government agency
Federal government agency
Public administration district
Private firm, for-profit business
Other – please specify:
Please choose all that apply.
Public health (including mental health, crisis intervention, health care)
Education
Transportation
Housing and shelter
Community improvement and capacity building
Environment (including gardening, climate change, forestry, ecological restoration, water and air protection, and land management)
Toxics/pollution related
Animal related
Human services (including day care, family services)
Youth
Economic development
Employment, job related
Legal services, civil rights
Arts, culture, creative practices
Recreation and sports (including birding and fishing)
Crime, criminal justice
International, foreign affairs, and national security
Research in science and/or technology
Faith-based activities
Power/electricity generation
Energy Efficiency
Private grant making foundation
Seniors
Food
Other – please specify:
Please choose one.
Public health (including mental health, crisis intervention, health care)
Education
Transportation
Housing and shelter
Community improvement and capacity building
Environment (including gardening, forestry, ecological restoration, water and air protection, and land management)
Toxics/pollution related
Animal related
Human services (including day care, family services)
Youth
Economic development
Employment, job related
Legal services, civil rights
Arts, culture, creative practices
Recreation and sports (including birding and fishing)
Crime, criminal justice
International, foreign affairs, and national security
Research in science and/or technology
Faith-based activities
Power/electricity generation
Energy Efficiency
Private grant making foundation
Seniors
Food
Other – please specify:
Section 5: Your group's stewardship activities
Please select one.
☐0-19%
☐20-39%
☐40-59%
☐60-79%
☐80-100%
Please choose all that apply.
Watershed / Sewershed
Stream / River / Canal
Waterfront / Beach / Shoreline
Wetland
Other
Natural / Restoration Area
Prairie
Forest/Woodland
Park
Community Garden
Urban farm
Playing field / Ball field / playground?
Dog run or dog park
Botanical Garden/Arboretum
Trails / Bike paths / Greenway / Rail-trail
Public Right of Way (Street ends, roadside, traffic island, greenstreet)
Street Tree
Residential building grounds (apartment courtyard, back yard, etc.)
Vacant land/Vacant lot
School yard or grounds; outdoor classroom
Grounds of public building other than school (e.g. city hall, library, hospital)
Courtyard / Atrium / Plaza
Flower box / Planter
Rain gardens, rain barrels, permeable pavement, bioswales
Green buildings
Rooftop
Brownfield property
Recreation center
Other – please specify:
Section 6: Where your group does stewardship
Please describe in detail the boundaries of where your group has physically done stewardship work within the past year. You can list multiple locations.
Examples: "On Main Street, between Maple and Crestview" —"the empty lot at 456 Broad Street " – "Jenkins Park" – "Northeast corner of the Lincoln Savanna" —"The Mary R. Stewart Nature Preserve" — “City of Elm Grove” – "ZIP code XXXXX" —"The West Side neighborhood in Madison" —"Washington County" —"the Green River Watershed" —"Statewide in Indiana"
Does your group have a Geographic Information System (GIS) file showing the boundaries of where you have done stewardship work within the past year that you would like to provide? Your GIS file will be used to accurately show your stewardship sites or territory on the online stewardship map. If you check ‘yes,’ the research team will contact you to get the file.
Yes ☐ No
Please choose all that apply.
Federal government
State government
County government
City/Local government
Other government (e.g. Port Authority)
Individual
Corporation (including joint ventures, real estate investment groups)
Nonprofit
Don't know
Other – please specify:
Please choose one.
Federal government
State government
County government
City/Local government
Other government (e.g. Port Authority)
Individual
Corporation (including joint ventures, real estate investment groups)
Nonprofit
Don't know
Other – please specify:
Section 7: The structure of your group
Note: for national or regional groups/organizations please tell us the approximate year your chapter was founded.
Note: for national groups/organizations please provide regional information.
Full-time Staff:
Part-time Staff: Members: Regular Volunteers:
Note: regular volunteers are those who routinely volunteer in your group's activities. This is different from volunteers who may come out for a single work day.
Hours:
$ ☐ Prefer not to answer
Please select one.
Government agencies
Foundations
Endowment
Individual memberships
Fees/program income
Corporate giving/sponsorship
Other:
Section
8:
Organizational
Services
Please select all that apply.
Educational curricula
Legal resources
Buildings/facilities
Plant materials/equipment
Technical assistance
Labor (volunteers/students/interns)
Grants
Community organizing
Computing / internet
Public relations/outreach
Data
Other:
Please select all that apply.
N/A, we don’t share information
National media
Local media
Direct mailing / newsletters
Door-to-door outreach
Flyers / signs
Website
Listserv
Blog
National conferences/meetings
Regional conferences/meetings
City conferences/meetings
Neighborhood-based conferences/meetings
Radio
TV
Other:
Section 9: Stewardship Networking
Please tell us about your group's relationship to other groups/organizations. Please list one group per box, additional boxes will appear if you need them.
[On the electronic version of the survey, additional entry slots will continue to appear as the existing ones fill up until the respondent has listed as many organizations as they wish.]
Please list groups that you go to for advice, data, or expertise related to stewardship or environmental issues. You can list as many as you wish.
[On the electronic version of the survey, additional entry slots will continue to appear as the existing ones fill up until the respondent has listed as many organizations as they wish.]
Please list groups/organizations/agencies you have gotten funding from in the last two years. You can list as many as you wish.
[On the electronic version of the survey, additional entry slots will continue to appear as the existing ones fill up until the respondent has listed as many organizations as they wish.]
Section 10: Final Section
This concludes the STEW-MAP survey.
Thank you for your participation.
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File Modified | 0000-00-00 |
File Created | 2021-01-24 |