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* 1. Date of Visit:

Date:

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* 2. Time of Visit:

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* 3. Is this your first visit to the Children's Museum?

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* 4. Are you a member of the Children's Museum?

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* 5. How did you find out about the Children's Museum? (please check all that apply)

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* 6. How old are the children visiting with you?

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* 7. Please rate the Children's Musuem in the following categories:

  Poor Fair Good Excellent N/A
Exhibits
Demonstrations / Programs
Value
Cleanliness

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* 8. What were your child(ren)'s favourite exhibits?

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* 9. What did your child(ren) enjoy the most?

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* 10. How likely are you to return to the Children's Museum for another visit?

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* 11. If you are not likely to return, why not?

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* 12. Overall, how satisfied are you with your experience at the Children's Museum?

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* 13. How could your experience have been improved today?

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* 14. Where are you visiting from?

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* 15. If from out of town, what brings you to London?

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* 16. Please tell us who you are:

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* 17. Sign me up to receive the latest news and promotions by subscribing to our e-Newsletter:

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