Fall ProStart Survey 2011

Complete this survey by September 16, 2011 and receive free SafeStaff Foodhandler Guides for your classroom.

Teacher Name(s): *

School Name: *

School Address:

City:

State:

ZIP Code:

School District: *

Email Address: *

Phone Number:

Number of Year One ProStart Students

Number of Year Two ProStart Students

Number of Students Working in the Industry

Number of Students Per Class

PROGRAM INFORMATION

Question Title

* How many classes of ProStart do you teach per day?

	None	1 class	2 classes	3 classes	4 classes	5+ classes
Monday	Monday None	Monday 1 class	Monday 2 classes	Monday 3 classes	Monday 4 classes	Monday 5+ classes
Tuesday	Tuesday None	Tuesday 1 class	Tuesday 2 classes	Tuesday 3 classes	Tuesday 4 classes	Tuesday 5+ classes
Wednesday	Wednesday None	Wednesday 1 class	Wednesday 2 classes	Wednesday 3 classes	Wednesday 4 classes	Wednesday 5+ classes
Thursday	Thursday None	Thursday 1 class	Thursday 2 classes	Thursday 3 classes	Thursday 4 classes	Thursday 5+ classes
Friday	Friday None	Friday 1 class	Friday 2 classes	Friday 3 classes	Friday 4 classes	Friday 5+ classes

None

1-3

4-6

Yes

Other (please specify)

Yes

	I would love to tell you about
Yes	Yes I would love to tell you about menu

Other