General Program Event Survey 2018 General Survey Thank you for attending the recent program event, Presented by our agency. This brief survey helps us improve our work in the communities we serve. Your answers will be kept anonymously. OK Question Title * 1. Program Date Date / Time Date OK Question Title * 2. Program Name OK Question Title * 3. AUDIENCE INFORMATIONPlease check all that currently applies to you.I am currently a(n): Athlete Student Parent Coach Teacher School Personnel Healthcare Providers Key Community Stakeholder Other (please specify) OK Question Title * 4. BEFORE attending this training, how would you rate your overall knowledge of the subject discussed today? Low Fair High Very high Low Fair High Very high OK Question Title * 5. Please indicate the extent to which this training increased your knowledge: A Great Deal Somewhat A Little Not At All Made me more aware Made me more aware A Great Deal Made me more aware Somewhat Made me more aware A Little Made me more aware Not At All Gave me new knowledge Gave me new knowledge A Great Deal Gave me new knowledge Somewhat Gave me new knowledge A Little Gave me new knowledge Not At All Positively changed my attitudes/belief Positively changed my attitudes/belief A Great Deal Positively changed my attitudes/belief Somewhat Positively changed my attitudes/belief A Little Positively changed my attitudes/belief Not At All OK Question Title * 6. Please rate your satisfaction of the presentation Very Satisfied Somewhat Satisfied Somewhat Dissatisfied Very Dissatisfied Very Satisfied Somewhat Satisfied Somewhat Dissatisfied Very Dissatisfied OK Question Title * 7. How likely are you to use the information or ideas presented today? Very Likely Somewhat Likely Not Likely Not at all Likely Very Likely Somewhat Likely Not Likely Not at all Likely OK Question Title * 8. Have you ever used a Medicine Drop Box? Yes No If not, why? (Optional) OK Question Title * 9. Comments / Suggestions OK Question Title * 10. Would you like to be added to out email/newsletter? (Optional) Valid Email address: OK DONE