Connelly Access Program 2010-2011 Field Trip/Assembly Evaluation

Exit this survey >>

 

*

1. School Name

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)

*

2. Evaluator Name

Evaluator Name

*

3. Evaluator's Position at School

Evaluator's Position at School   Principal Vice-Principal Classroom Teacher Music Teacher Art Teacher

Other (please specify)

*

4. Field Trip/Assembly Date

	MM		DD		YYYY
Date	Field Trip/Assembly Date   Date   Month	/	Day	/	Year

*

5. Organization providing Assembly/Field Trip

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

*

6. Grades attending the Field Trip/Assembly

Grades attending the Field Trip/Assembly   4 5 6 7 8

Other (please specify)

*

7. Total number of buses used for Field Trip

Total number of buses used for Field Trip   None-Assembly 1 2 3 4 5 6 7 8 9 10

Other (please specify)

*

8. Total number of students attending the Field Trip/Assembly

Total number of students attending the Field Trip/Assembly   10-40 41-80 81-120 121-160 161-200 201-240

Other (please specify)

9. Bus Company Used

Bus Company Used

*

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

Did the Field Trip/Assembly supplement your school curriculum?   Very Much

Somewhat

Not at all

*

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

Did you receive preparatory material prior to the Field Trip/Assembly?   Yes

No

*

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

Did you use the preparatory material with your students beforehand?   Yes

No

*

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

Will you use follow-up suggestions with your students?   Yes

No

*

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

Was this your first Field Trip/Assembly with this organization?   Yes

No

*

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

For how many of your students was this a first time experience?   All

Most

Some

None

*

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

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

2

3

4

5

17. Additional Comments

Additional Comments