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❤️ Nonprofit & Community

Free Program Impact Assessment Template

Rate a program against the five DAC-style dimensions — relevance, effectiveness, efficiency, impact, sustainability — and get a per-program AI report.

5 criteria
~15 min
AI review report
Live Preview

Quick answer

Use it at review time to score a program against the five OECD-DAC criteria — relevance, effectiveness, efficiency, impact, sustainability — with evidence attached per item, assembled into a one-page report funders, boards and the team itself can argue with.

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About this template

Impact claims without a structure are adjectives. This assessment scores a program against five criteria in the OECD-DAC tradition — relevance, effectiveness, efficiency, impact, sustainability — with evidence attached item by item, and the AI report assembles the rated dimensions into a one-page review that funders, boards and the team itself can argue with. Honest enough to hurt, structured enough to use.

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Live Preview

Sample form and report preview — live and ready to fill in.

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Fill it in to see how responses flow.
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Sample AI report with scoring visuals and recommendations, printable as a PDF.
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What's Included

Everything you need to run this template.

1

Five criteria

Relevance, effectiveness, efficiency, impact, sustainability — rated separately.

2

Evidence per item

No bare scores: each rating names its proof.

3

Period framing

Baseline versus now keeps the review about change, not mood.

4

AI review report

One page assembling dimensions, evidence and the soft spots.

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How It Works

From copy to deliverable in four steps.

1

Use this template

Copy it in; scope items to one program or a cohort.

2

Rate with evidence

Answer as the delivery team first, then invite partners.

3

Read the report

The AI summary assembles the five dimensions onto one page.

4

Argue and adjust

Board, funder and team react to the same dated document.

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Who Is This For

Pick your role — see how it fits your workflow.

1

Program directors

Defend impact claims with a structured, evidence-tagged file.

2

Boards

One page, five dimensions — strategy meetings stop being theatre.

3

Funders and partners

Comparability across grantees without forcing one template on all.

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Key Features

What makes this template work as a professional deliverable.

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Sample Questions Inside

A preview of the real questions in this form — exactly what respondents see.

  1. Was this program aimed at a need the community confirms? (1–5)
  2. Did intended changes happen for the people you prioritized? (1–5)
  3. Cost per served participant versus similar work (1–5)
  4. Side effects — good and bad — documented? (1–5)
  5. Would results survive next year without this funding? (1–5)
  6. Name the evidence behind your strongest rating (open)
  7. What would change your lowest rating next year? (open)
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Frequently Asked Questions

Why does impact need its own assessment, separate from the outcome survey?
Outcomes report what participants say changed; impact review weighs whether the program was the cause, at what cost, and whether it lasts. It adds relevance, efficiency and sustainability lanes the outcome survey doesn't run in.
Where do the five dimensions come from?
They follow the OECD-DAC criteria tradition — relevance, effectiveness, efficiency, impact, sustainability — adapted to self-review, not external evaluation.
Is the AI report an evaluation?
No — it assembles your team's ratings and stated evidence into a review document. Independent claims still need independent verification.
Is it free to use?
Yes. Copy it into your FormLM workspace; each assessed program yields one printable AI report.
Can we compare several programs?
Yes — the same instrument across programs makes dimension curves comparable; keep scopes honest (one program, one entry set).
Self-review bias?
The method note in every report invites dissent; run the delivery team and the board passes separately and compare.

Turn impact talk into an evidence file

Five DAC dimensions, proof per item, one AI review page per program.