Evaluator Name

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* 2. Evaluator Name

Evaluator's Position at School

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* 3. Evaluator's Position at School

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

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

Date
Grades attending the Field Trip/Assembly/Residency (check all that apply)

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* 6. Grades attending the Field Trip/Assembly/Residency (check all that apply)

Bus Company Used (if applicable)

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* 7. Bus Company Used (if applicable)

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

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

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

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

Did you use the preparatory material with your students beforehand?

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* 10. Did you use the preparatory material with your students beforehand?

Was this your first Field Trip/Assembly/Residency with this organization?

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* 11. Was this your first Field Trip/Assembly/Residency with this organization?

For how many of your students was this a first time experience?

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* 12. For how many of your students was this a first time experience?

Please rate this Field Trip/Assembly/Residency on a scale of 1 to 5.

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* 13. Please rate this Field Trip/Assembly/Residency on a scale of 1 to 5.

Do you have any suggestions for other organizations we should consider for inclusion in this program? What field trips, assemblies, or residencies would you like to experience?

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* 14. Do you have any suggestions for other organizations we should consider for inclusion in this program? What field trips, assemblies, or residencies would you like to experience?

Additional Comments - We appreciate your honest feedback!

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* 15. Additional Comments - We appreciate your honest feedback!

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