* 1. Name and Phone Number

* 2. Date of Event

Date / Time

* 3. Event Name/Location

* 4. The youth enjoyed their experience.

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

* 6. The instructor was a good teacher.

* 7. The program was conducted safely

* 8. The office staff was helpful.

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

* 10. Type of Event & Additional Comments

T