School Program Impact Survey
Help us evaluate the effectiveness of our school program by sharing your feedback and experiences.
Full Name
*
First Name
Last Name
Your Role
*
Student
Parent/Guardian
Teacher/Staff
Other
Program Name
*
Date of Participation
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Overall, how satisfied are you with the program?
*
1
2
3
4
5
Please rate the following aspects of the program:
*
Rows
Very Poor
Poor
Average
Good
Excellent
Program Content
1
2
3
4
5
Instructor Quality
6
7
8
9
10
Organization
11
12
13
14
15
Relevance to Needs
16
17
18
19
20
Engagement Level
21
22
23
24
25
What positive changes or outcomes have you observed as a result of this program?
Improved academic performance
Increased motivation
Better social skills
Greater confidence
Other
How likely are you to recommend this program to others?
*
Not likely at all
1
2
3
4
5
6
7
8
9
Extremely likely
10
1 is Not likely at all, 10 is Extremely likely
What did you like most about the program?
What could be improved in future programs?
Additional comments or suggestions
Submit Survey
Should be Empty: