# Program Evaluation Form # Mayflower Church **Program Evaluation Form** *Checkup Loop Conversation Guide* ## Program Information
**Program Name:**
**Ministry Leader(s):**
**Elder(s) Present:**
**Date of Evaluation:**
**Evaluation Period:** (e.g., Q1 2026, Fall 2025, Annual 2025)
## Phase 3: Evaluation *Using the Checkup Loop approach: regular two-way conversations between Elders and frontline ministry leaders.* ### Focus Area 1: Direction (Completed by Leader(s) prior to the meeting) **Key Question:** Is the program moving toward its intended purpose and advancing the mission, vision, and values of Mayflower Church? **Color Rating (circle one):**
**GREEN Thriving****YELLOW Needs Attention****RED Critical**
**Why did you vote the way you voted?**
### Focus Area 2: Health **Key Question:** Are participants and leaders experiencing spiritual vitality? **Color Rating (circle one):**
**GREEN Thriving****YELLOW Needs Attention****RED Critical**
**Why did you vote the way you voted?**
Focus Area 3: Scope of Impact **Key Question:** Who is being reached and served? **Color Rating (circle one):**
**GREEN Thriving****YELLOW Needs Attention****RED Critical**
**Why did you vote the way you voted?**
### Focus Area 4: Growth **Key Question:** Are people growing spiritually and relationally? **Color Rating (circle one):**
**GREEN Thriving****YELLOW Needs Attention****RED Critical**
**Why did you vote the way you voted?**
### Focus Area 5: Changed Lives **Key Question:** What stories of transformation can we celebrate? **Color Rating (circle one):**
**GREEN Thriving****YELLOW Needs Attention****RED Critical**
**Why did you vote the way you voted?**
**Relational Checkup Questions (Completed by Elder(s) during meeting)** *Use these questions to guide deeper conversation:* **1. What stories of life change have you witnessed in this program?**
**2. How are people experiencing God through this ministry?**
**3. What relationships are being built or strengthened?**
**4. Where do you see joy in this ministry? Where is joy lacking?**
**5. What barriers are preventing people from growing spiritually?**
**6. Are leaders empowered to use their gifts and make decisions?**
**7. What would need to change for this program to be more effective?**
**8. Is this program sustainable with current resources?**
## Phase 4: Adaptation (Re-Planning) *Use the simple Keep/Stop/Start framework:* ### KEEP: What is working well and should continue?
### STOP: What is not bearing fruit or creating unnecessary burden?
### START: What new approaches should we try based on what we've learned?
## Action Steps & Next Evaluation **Key Action Items from this Evaluation:**
**Action Item****Responsible Person**
**Date of Next Evaluation:**
◆ ◆ ◆ *Remember: The goal is not perfect evaluation, but faithful stewardship of the ministries entrusted to us for God's glory and people's good.* **POST EVALUATION ACTIONS:** 1. Submit original to the Church Clerk. 2. Church Clerk to scan the document as PDF and save it in the Program Evaluations folder in the Leadership Pipeline Shared Google Drive. \[Filename: “YYYYMM ProgramName Evaluation”\] 3. Clerk will share the file to Servants Council members via email.