In an effort to ensure and maintain a high quality program for you and your child, we would greatly appreciate your assistance in completing and submitting this form.

Your input is greatly appreciated.

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* 1. Date:

Date

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* 2. Number of Children attending SCOPE:

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* 3. The staff maintains a safe and pleasant indoor environment.

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* 4. The children are supervised properly while outdoors.

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* 5. The activities are varied and interesting.

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* 6. My children are given opportunities to choose their activities.

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* 7. My children are given the opportunity to work on homework each day.

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* 8. I am satisfied with the snacks my children are offered.

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* 9. The staff genuinely cares about the children.

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* 10. The staff handles discipline in a fair and constructive manner.

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* 11. The staff conducts themselves in a professional manner.

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* 12. The program provides a nurturing and enriching environment for children.

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* 13. Please feel free to use this space to comment on any of your responses.

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* 14. We also value your children's opinion. Please take the time to assist your children in answering the follow-
ing questions.

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* 15. What is your favorite activity at SCOPE?

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* 16. What additional activities would you like SCOPE to offer?

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* 17. Additional comments.

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* 18. Please feel free to use this space to comment on any of your responses.

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* 19. Email address (optional):

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* 20. Name (optional)

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* 21. Program Site:

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