Exit this survey Safety Ambassador 1. Safety Ambassador Feedback Form This information will be used to help the National Safety Council improve the Safety Ambassador program. We appreciate your taking the time to complete this short survey. Thank you. Question Title * 1. What is your zip code? Question Title * 2. Did the information we provided meet your needs? Yes No Question Title * 3. Was the information easy for you to present? Yes No Question Title * 4. Who did you share this information with? Local business School Family and friends Church/Religious group Local community event Other (please specify) Question Title * 5. How many people did you reach? Question Title * 6. Was the information easy for them to understand? Yes No Question Title * 7. What type of response did you receive from those you presented to? Very interested Somewhat interested Neutral Somewhat uninterested Very uninterested Question Title * 8. How could we improve this outreach program? Question Title * 9. What is your email address? Done