Program Evaluation
Page One
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1.
Program Name:
*
This question is required
2.
Instructor Name:
*
This question is required
3.
Day(s) of week:
*
This question is required
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
4.
Class Start Time
*
This question is required
5.
Instructor was prepared & organized
*
This question is required
Very Satisfied
Satisfied
Neutral
Dissatisfied
Very Dissatisfied
Not Applicable
6.
Enthusiasm of instructor
*
This question is required
Very Satisfied
Satisfied
Neutral
Dissatisfied
Very Dissatisfied
Not Applicable
7.
Child was kept active and on task
*
This question is required
Very Satisfied
Satisfied
Neutral
Dissatisfied
Very Dissatisfied
Not Applicable
8.
Completion of program objectives
*
This question is required
Very Satisfied
Satisfied
Neutral
Dissatisfied
Very Dissatisfied
Not Applicable
9.
What classes, camps, or special events would you like to see in the future?
10.
Are you satisfied with the day(s) and time(s) that this program is offered? If no, please explain.
11.
Are you registered in any other programs or use any other services?
Yes
No
12.
Additional Comments
13.
Contact Information (Optional)
Name, Phone, Email:
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