Connelly Access Program 2010-2011 Field Trip/Assembly Evaluation

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* 1. School Name

Annunciation BVM

Christ the King

DePaul Catholic

Holy Spirit

Mother of Divine Grace

Our Lady of Port Richmond

Our Mother of Sorrows-St. Ignatius

Pope John Paul II Catholic

Sacred Heart of Jesus

St. Anne

St. Anselm

St. Athanasius-Immaculate Conception

St. Christopher

St. Dominic

St. Francis De Sales

St. Helena

St. Jerome

St. Laurentius

St. Martha

St. Peter the Apostle

St. Rose of Lima

St. William

Other (please specify)

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* 2. Evaluator Name

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* 3. Evaluator's Position at School

Principal

Vice-Principal

Classroom Teacher

Music Teacher

Art Teacher

Other (please specify)

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* 4. Field Trip/Assembly Date

Date

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* 5. Organization providing Assembly/Field Trip

1807 & Friends/Wister Quartet

African American Museum of Philadelphia

Arden Theatre

AMLA

Chestnut Brass Company

Dance Affiliates

Franklin Institute

Freedoms Foundation

Kimmel Center

National Liberty Museum

Philadephia Civic Ballet

Philadelphia Museum of Art

Philadelphia Orchestra

Philadelphia Zoo

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* 6. Grades attending the Field Trip/Assembly

Other (please specify)

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* 7. Total number of students attending the Field Trip/Assembly

10-40

41-80

81-120

121-160

161-200

201-240

Other (please specify)

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* 8. Total number of buses used for Field Trip

None-Assembly

Other (please specify)

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* 9. Bus Company Used

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* 10. Did the Field Trip/Assembly supplement your school curriculum?

Very Much

Somewhat

Not at all

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* 11. Did you receive preparatory material prior to the Field Trip/Assembly?

Yes

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* 12. Did you use the preparatory material with your students beforehand?

Yes

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* 13. Will you use follow-up suggestions with your students?

Yes

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* 14. Was this your first Field Trip/Assembly with this organization?

Yes

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* 15. For how many of your students was this a first time experience?

All

Most

Some

None

Connelly Access Program 2010-2011 Field Trip/Assembly Evaluation

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* 1. School Name

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* 2. Evaluator Name

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* 3. Evaluator's Position at School

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* 4. Field Trip/Assembly Date

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* 5. Organization providing Assembly/Field Trip

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* 6. Grades attending the Field Trip/Assembly

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* 7. Total number of students attending the Field Trip/Assembly

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* 8. Total number of buses used for Field Trip

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* 9. Bus Company Used

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* 10. Did the Field Trip/Assembly supplement your school curriculum?

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* 11. Did you receive preparatory material prior to the Field Trip/Assembly?

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* 12. Did you use the preparatory material with your students beforehand?

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* 13. Will you use follow-up suggestions with your students?

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* 14. Was this your first Field Trip/Assembly with this organization?

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* 15. For how many of your students was this a first time experience?

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* 16. Please rate this Field Trip/Assembly on a scale of 1 to 5 (1=Lowest/5=Highest).

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* 17. Additional Comments