Please fill out the following information after your school visits. Please fill out 1 per VENUE (ie- If you have two performances at the same school, only one survey is needed).

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* 1. Name

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* 2. Date and Time of Storytime(s)

Date
Time
Date
Time
Date
Time

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* 3. Name of school/venue

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* 4. How many students attended the performance?

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* 5. What questions were asked?

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* 6. Comments/Notes

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* 7. Anything else to note about today's performance or venue?

T