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1.
Cootie Shots
Teacher Survey
1
. What grade do you teach (or bring to the play)?
What grade do you teach (or bring to the play)?
2nd grade
3rd grade
4th grade
5th grade
2
. Did you find this program to be age appropriate for your students?
Did you find this program to be age appropriate for your students?
Yes
No
Why or why not?
3
. Which scenes or storylines did you find most effective? Why?
Which scenes or storylines did you find most effective? Why?
4
. Which did you find least effective? Why?
Which did you find least effective? Why?
5
. Are there issues of diversity or bullying that you deal with in the classroom or that you expected to see in
Cootie Shots
today, but did not?
Are there issues of diversity or bullying that you deal with in the classroom or that you expected to see in
Cootie Shots
today, but did not?
Yes
No
What are they?
6
. What kinds of reactions did you get from your students following the performance?
What kinds of reactions did you get from your students following the performance?
7
. Do you feel that this performance made a positive impact on your class?
Do you feel that this performance made a positive impact on your class?
Yes
No
Please explain:
8
. OPTIONAL: What school do you represent?
OPTIONAL: What school do you represent?
9
. Please let us know any additional comments:
Please let us know any additional comments:
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