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* 1. Name and Phone Number

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* 2. Date of Event

Date / Time

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* 3. Event Name/Location

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* 4. The youth enjoyed their experience.

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* 5. Overall, I'm satisfied with the program.

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* 6. The instructor was a good teacher.

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* 7. The program was conducted safely

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* 8. The office staff was helpful.

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* 9. I would like to participate in a city program again.

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* 10. Type of Event & Additional Comments

T