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Instructor/Facilitator Feedback
1. General Information
We are collecting this information so we may evaluate our programs. Please read each question carefully. Your responses help us make sure we are meeting our mission.
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1
. Date of presentation
MM
DD
YYYY
Date
Date of presentation Date Month
/
Day
/
Year
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2
. Name of Presenter:
Name Of Presenter
Name of Presenter:
Kathleen Gerus
Pamela Foote
Other
Name of Presenter: Name of Presenter: Name Of Presenter
Other (please specify)
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3
. How many students were present?
How many students were present?
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4
. Which grades/ages participated? (Please select all that apply.)
Which grades/ages participated? (Please select all that apply.)
11 - 13
14 - 18
19 - 25
25 - 45
45 & Above
20%
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