Experiment Feedback Science Assessment Form
Please provide your feedback and assessment of the science experiment. Your responses will help us improve future experiments and understand your learning experience.
Participant Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Grade/Class Level
*
Please Select
5th Grade
6th Grade
7th Grade
8th Grade
High School
Other
Experiment Title
*
Date of Experiment
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
How clearly were the experiment instructions explained?
*
1
2
3
4
5
Assessment of Scientific Understanding
*
Rows
Not at all
Somewhat
Mostly
Completely
I understood the scientific concept behind the experiment.
1
2
3
4
I could explain the experiment to someone else.
5
6
7
8
I can apply what I learned to new situations.
9
10
11
12
How engaging did you find the experiment?
*
Not engaging
1
2
3
4
Very engaging
5
1 is Not engaging, 5 is Very engaging
What difficulties, if any, did you face during the experiment?
What did you enjoy most about the experiment?
Suggestions for improving this experiment or future experiments
Would you recommend this experiment to others?
*
Yes
No
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