Connelly Access Program 2011-2012 Field Trip/Assembly Evaluation

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* 1. School Name

St. Donato

Epiphany of Our Lord

St. Francis Xavier

St. Gabriel

St. Malachy

St. Martin DePorres

Mary, Mother of Peace

St. Monica

Our Lady of Lourdes

Our Lady of Mt. Carmel

St. Thomas Aquinas

Visitation B.V.M.

St. Bridget

St. Cecilia

St. George

Holy Cross

Immaculate Heart of Mary

Incarnation of Our Lord

St. Martin of Tours

Maternity B.V.M.

St. Matthew

Our Lady of Consolation

Our Lady of Ransom

Our Mother of Consolation

St. Raymond of Penafort

Resurrection of Our Lord

St. Veronica

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/Residency Date
(For a residency, enter any date during the program.)

Date

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* 5. Organization providing Assembly/Field Trip/Residency

1807 & Friends/Wister Quartet

Academy of Natural Sciences

African American Museum of Philadelphia

American Swedish Historical Museum

Arden Theatre

AMLA

Bartram's Garden

Chestnut Brass Company

Clay Studio

Franklin Institute

Freedoms Foundation

Musicopia

Mutter Museum

National Liberty Museum

Philadelphia Museum of Art

Philadelphia Orchestra

Rock School for Dance

Walnut Street Theatre

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* 6. Grades attending the Field Trip/Assembly/Residency

Other (please specify)

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

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 (In-School Assembly or Residency)

Other (please specify)

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

Very Much

Somewhat

Not at all

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* 10. Bus Company Used

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

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/Residency 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 2011-2012 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/Residency Date
(For a residency, enter any date during the program.)

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* 5. Organization providing Assembly/Field Trip/Residency

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* 6. Grades attending the Field Trip/Assembly/Residency

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

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* 8. Total number of buses used for Field Trip

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

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* 10. Bus Company Used

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

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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/Residency 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/Residency on a scale of 1 to 5 (1=Lowest/5=Highest).

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* 17. Additional Comments

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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/Residency Date(For a residency, enter any date during the program.)

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* 5. Organization providing Assembly/Field Trip/Residency

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* 6. Grades attending the Field Trip/Assembly/Residency

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

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* 8. Total number of buses used for Field Trip

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

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* 10. Bus Company Used

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

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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/Residency 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/Residency on a scale of 1 to 5 (1=Lowest/5=Highest).

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* 17. Additional Comments

* 4. Field Trip/Assembly/Residency Date
(For a residency, enter any date during the program.)