BLAZES Student Evaluation

Please tell us your honest answers to these questions so we can make our programs better.

1. School District

School District Berkeley

Oakland

West Contra Costa

Other (please specify)

2. Name of School

Name of School

3. Name of Teacher on Visit

Name of Teacher on Visit

4. Date of Visit

Date of Visit

5. Please rate the following activities:

	Fantastic	Good	OK	Horrible	Did Not Do
The periodic table and metal blocks	*Please rate the following activities: The periodic table and metal blocks Fantastic	The periodic table and metal blocks Good	The periodic table and metal blocks OK	The periodic table and metal blocks Horrible	The periodic table and metal blocks Did Not Do
Electricity with the meters	Electricity with the meters Fantastic	Electricity with the meters Good	Electricity with the meters OK	Electricity with the meters Horrible	Electricity with the meters Did Not Do
Dry ice and the fire triangle	Dry ice and the fire triangle Fantastic	Dry ice and the fire triangle Good	Dry ice and the fire triangle OK	Dry ice and the fire triangle Horrible	Dry ice and the fire triangle Did Not Do
Metal bars and birthday candles	Metal bars and birthday candles Fantastic	Metal bars and birthday candles Good	Metal bars and birthday candles OK	Metal bars and birthday candles Horrible	Metal bars and birthday candles Did Not Do
Liquid nitrogen	Liquid nitrogen Fantastic	Liquid nitrogen Good	Liquid nitrogen OK	Liquid nitrogen Horrible	Liquid nitrogen Did Not Do
Advanced Light Source tour	Advanced Light Source tour Fantastic	Advanced Light Source tour Good	Advanced Light Source tour OK	Advanced Light Source tour Horrible	Advanced Light Source tour Did Not Do
Overall rating for visit	Overall rating for visit Fantastic	Overall rating for visit Good	Overall rating for visit OK	Overall rating for visit Horrible	Overall rating for visit Did Not Do

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6. List one thing you learned today:

List one thing you learned today:

7. What would you like to learn more about?

What would you like to learn more about?

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