HTMP FALL SURVEY 2016

Please complete this survey no later than September 16, 2016 to receive free HTMP curriculum.

Question Title

* SCHOOL INFORMATION

Teacher Name(s): *

School Name: *

School Address:

City:

State:

ZIP Code:

School District: *

Email Address: *

Phone Number:

Question Title

* STUDENT INFORMATION

Number of Year One HTMP Students:

Number of Year Two HTMP Students:

Number of Students Working in the Industry:

Number of Students Per Class:

PROGRAM INFORMATION

Question Title

* How many classes of HTMP do you teach per day?

	None	1 class	2 classes	3 classes	4 classes	5+ classes
Monday	Monday None	Monday 1 class	Monday 2 classes	Monday 3 classes	Monday 4 classes	Monday 5+ classes
Tuesday	Tuesday None	Tuesday 1 class	Tuesday 2 classes	Tuesday 3 classes	Tuesday 4 classes	Tuesday 5+ classes
Wednesday	Wednesday None	Wednesday 1 class	Wednesday 2 classes	Wednesday 3 classes	Wednesday 4 classes	Wednesday 5+ classes
Thursday	Thursday None	Thursday 1 class	Thursday 2 classes	Thursday 3 classes	Thursday 4 classes	Thursday 5+ classes
Friday	Friday None	Friday 1 class	Friday 2 classes	Friday 3 classes	Friday 4 classes	Friday 5+ classes

Question Title

* Which curriculum are you currently using?

LMP, Year One

LMP, Year Two

HTMP, Year One

HTMP, Year Two

START

None of the Above

Other (please specify)

Question Title

* Number of fund raising events each semester:

None

1-3

4-6

Question Title

* Do you participate in FRLA Chapter events?

Yes

Other (please specify)

Question Title

* Are you receiving information about FRLA Chapter events either through email or mail?

Yes

Question Title

* If you are not receiving information about FRLA Chapter events, would you like to be added to the distribution list?

Yes

Question Title

* Would you be interested in submitting an article for NewsBites about your program?

	I would love to tell you about
Yes	Yes I would love to tell you about menu

Other

Question Title

* Thank you for completing the Fall HTMP Survey. For completing the survey, you receive $500 in free HTMP curriculum. In order to receive your free curriculum, please indicate below the curriculum you would like to receive, up to $500.

	Student Textbook $82/each	Teacher Kit $450	Student Workbook with scantron $50/each	Individual DVD $120 each (YEAR ONE ONLY)	Individual DVD $120/each (YEAR ONE ONLY)
HTMP YEAR ONE	HTMP YEAR ONE Student Textbook $82/each menu	HTMP YEAR ONE Teacher Kit $450 menu	HTMP YEAR ONE Student Workbook with scantron $50/each menu	HTMP YEAR ONE Individual DVD $120 each (YEAR ONE ONLY) menu	HTMP YEAR ONE Individual DVD $120/each (YEAR ONE ONLY) menu
HTMP YEAR TWO	HTMP YEAR TWO Student Textbook $82/each menu	HTMP YEAR TWO Teacher Kit $450 menu	HTMP YEAR TWO Student Workbook with scantron $50/each menu	HTMP YEAR TWO Individual DVD $120 each (YEAR ONE ONLY) menu	HTMP YEAR TWO Individual DVD $120/each (YEAR ONE ONLY) menu