School or Group:

Position: If Teacher, Grade Level:

Date of Outreach Program:

Name of Program:

e-Mail Address

 Please fill out the appropriate answer:

1.     How would you rate the overall impact of the program? Excellent Good Fair Poor

2.     Was the program relevant to your curriculum and/or classroom subject? Yes No

3.     How would you rate the presentation as a program generating interest in your course of study? Excellent Good Fair Poor

4.     Would you have this program again next year?
Yes                  No (If no, Why?)

5.     Would you recommend this program to others?
Yes                  No (If no, Why?)

6.     What other outreach programming from History Out Of the Box, Inc. would you like to see offered?

Comments: