Community Program Participant Satisfaction Check-in
Please help us improve our community programs by sharing your honest feedback about your experience.
Participant Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Which community program did you participate in?
*
Please Select
Youth Leadership Workshop
Senior Wellness Program
Family Activity Day
Arts & Culture Series
Other
How did you hear about this program?
Community Center
Social Media
Friend or Family
Flyer/Poster
Other
Please rate your satisfaction with the following aspects of the program:
*
Rows
Very Dissatisfied
Dissatisfied
Neutral
Satisfied
Very Satisfied
Program Organization
1
2
3
4
5
Facilitators/Staff
6
7
8
9
10
Activities/Content
11
12
13
14
15
Facilities/Location
16
17
18
19
20
Communication
21
22
23
24
25
Overall, how would you rate your experience with this program?
*
1
2
3
4
5
What did you enjoy most about the program?
What could we improve for future programs?
Would you recommend this program to others?
*
Yes
No
Please share any additional comments or suggestions:
Submit Feedback
Should be Empty: