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.

* 1. What is your zip code?

* 2. Did the information we provided meet your needs?

* 3. Was the information easy for you to present?

* 4. Who did you share this information with?

* 5. How many people did you reach?

* 6. Was the information easy for them to understand?

* 7. What type of response did you receive from those you presented to?

* 8. How could we improve this outreach program?

* 9. What is your email address?