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* 1. Who are you?

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* 2. We participated in the following Child Abuse
Prevention Month activities:

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* 3. Who did you distribute literature to?

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* 4. What special event did you host?

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* 5. Did you distribute blue ribbons?

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* 6. How many ribbons did you distribute?

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* 7. Please estimate how many people you reached
with awareness activities

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* 8. Which of the packet pieces did you use? (Check all that apply.) Left side of Packet

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* 9. Which of the packet pieces did you use? (Check all that apply.) Right Side of Packet

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* 10. Which of your activities was most successful?

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* 11. Which of your activities was least successful?

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* 12. What ideas do you have for next year’s packet? For instance, is there anything you would have liked in this year’s packet that was not there?

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* 13. Please send us samples of materials you produced and articles about your activities. They are very help-ful to other groups who wish to observe Child Abuse Prevention Month.

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