EmailMe Form - Molly's Fire Safety Skype Program Evaluation Form

Date of program *

Name *

First Last

Phone *

### - ### - ####

Email *

School *

Did the program meet your expectations? *

Comments

How would you rate the quality of the content presented during the program? *

Comments

How would you rate the quality of the educational materials and activities? *

Comments

How would you rate your overall satisfaction of the program? *

Comments

Would you recommend our program to other teachers? *

Comments

Do you have any suggestions on how we can improve our fire safety Skype program? *

Yes

No

If yes, please feel free to share your comments

What qualitative evidence, if any, is there that students understood the concepts presented?

How did you hear about our program? *

May we use your comments, including your name in our literature and on our website? *

Yes

No

Comments

Please feel free to share pictures from your students.

Additional comments? Please feel free to add them here.