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* 1. Email (optional for participation prize)

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* 2. Full Name (for raffle prize drawing)

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* 3. I am:

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* 4. Age

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* 5. I am a:

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* 6. What community are you from?

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* 7. The knowledge of the presenter on topic presented:

  1 2 3 4 5
Scale of 1 to 5 (1 being the lowest and 5 being the highest)

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* 8. How useful was the presentation to you?

  1 2 3 4 5
Scale 1 not that useful, 5 very useful

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* 9. The overall presentation:

  1 2 3 4 5
Scale of 1 to 5 (1 being the lowest and 5 being the highest)

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* 10. How did you find out about the PUSD Diné Stories & Teachings Night event?

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* 11. What other cultural presentations would you like PUSD to offer?

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* 12. What other presenters would you recommend, please provide name and contact information.

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* 13. Any other comments or suggestions?

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* 14. Would you like to receive updates from Johnson O’Malley Indian Education Committee members regarding meetings, events, and activities?

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