1. Program/Class Name: 2. R.E.A.C.H. Online Activity Number: 3. Program/Class End Date: 4. Instructor Name (if applicable):
5. Are you a returning patron to our program/class? Yes No
6. Was the cost reasonable? Yes No
7. Was the staff accessible and helpful? Yes No
8. Was the facility clean? Yes No
9. How did you hear about the program/class? Brochure Flyer Cable Website Other
10. How would you rate the registration process? Yes No
11. Did the program/class meet expectations? Yes No
12. Was the program/class organized? Yes No
13. Would you recommend this program/class to someone? Yes No
14. How would you rate the program/class overall? Excellent Good Average Below Average Poor
15. Did your instructor show a concern for safety? Yes No
16. Did the instructor treat participant with respect? Yes No
17. Was the instructor positive and motivating? Yes No
18. How would you rate the instructor overall? Excellent Good Average Below Average Poor
19. What did you like the most and/or least?
20. What other programs/classes would you like to see in the future?
21. Any additional comments?
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