1.

We hope to learn about program successes and areas for improvement. Your honesty is important - please answer the questions as truthfully as possible. Your answers will be held confidential and will not be shared with your colleagues.

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* 1. What was your role in the residency?

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* 2. What art forms occurred in your residency? (Check all that apply)

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* 3. What is the name of your school/site?

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* 4. What day of the week did the residency take place? Please check all that apply.

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* 5. What time did the residency start each week?

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* 6. What is the name of the artist you worked with?

Next we’d like to ask you about your observations of students now and at the beginning of the residency.

Please tell us how your students' creative thinking skills may have changed as a result of this arts program. Please choose the number that corresponds with your degree of agreement with the statements.

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* 7. Students actively engaged with new materials or activities by performing simple investigations.

  Strongly Disagree “1” 2 3 4 5 6 7 8 9 Strongly Agree “10”
At present
At the start of the residency

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* 8. Some students in the classroom demonstrated independent thinking in their movement, dance improvisation, or art activities.

  Strongly Disagree “1” 2 3 4 5 6 7 8 9 Strongly Agree “10”
At present
At the start of the residency

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* 9. Students use language, physical expression or visual expression to communicate creatively.

  Strongly Disagree “1” 2 3 4 5 6 7 8 9 Strongly Agree “10”
At present
At the start of the residency
Please tell us how your students' relationships may have changed as a result of this arts program. Please choose the number that corresponds with your degree of agreement with the statements.

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* 10. Students are able to form healthy relationships with their peers.

  Strongly Disagree “1” 2 3 4 5 6 7 8 9 Strongly Agree “10”
At present
At the start of the residency

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* 11. Students are able to form healthy relationships with adults.

  Strongly Disagree “1” 2 3 4 5 6 7 8 9 Strongly Agree “10”
At present
At the start of the residency

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* 12. Students work cooperatively and support one another.

  Strongly Disagree “1” 2 3 4 5 6 7 8 9 Strongly Agree “10”
At present
At the start of the residency
Please tell us how your students' focus and concentration skills may have changed as a result of this arts program. Please choose the number that corresponds with your degree of agreement with the statements.

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* 13. Students are able to follow increasingly complex instructions and concentrate on the activity at hand.

  Strongly Disagree “1” 2 3 4 5 6 7 8 9 Strongly Agree “10”
At present
At the start of the residency

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* 14. Students persist when learning new movements, songs or using new art materials.

  Strongly Disagree “1” 2 3 4 5 6 7 8 9 Strongly Agree “10”
At present
At the start of the residency
Please tell us how your students' peer critique skills may have changed as a result of this arts program. Please choose the number that corresponds with your degree of agreement with the statements.

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* 15. Students are able to reflect verbally on what they just saw, experienced, or created (i.e. series of movements, visual artwork, etc.).

  Strongly Disagree “1” 2 3 4 5 6 7 8 9 Strongly Agree “10”
At present
At the start of the residency

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* 16. Students identify key characteristics about their classmates’ work.

  Strongly Disagree “1” 2 3 4 5 6 7 8 9 Strongly Agree “10”
At present
At the start of the residency
Please tell us how your students' artistic vocabulary may have changed as a result of this arts program. Please choose the number that corresponds with your degree of agreement with the statements.

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* 17. Students can perform/ create art in different ways when asked.

  Strongly Disagree “1” 2 3 4 5 6 7 8 9 Strongly Agree “10”
At present
At the start of the residency

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* 18. Students have learned artistic vocabulary.

  Strongly Disagree “1” 2 3 4 5 6 7 8 9 Strongly Agree “10”
At present
At the start of the residency

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