Youth Development
Healthy Living
Social Responsibility

Adult Program Survey

Name of Class:*
Day of the Week:
Month That You Took The Class:
Instructor Name:
Are You Male or Female:
Your Name (Completely Optional):
On a scale of 1 to 5, please indicate your satisfaction with the following areas. '1' is 'Poor''3' is 'Average';  and '5' is 'Excellent'.
Quality of Instruction:
Instructor Communicates With Participants:
Improvement in Participant's Skills:
Equipment Condition/Cleanliness of Space:
Was Space Appropriate for Class Activity:

Do you have any additional comments? If you would like a response from a member of the Program Committee, or from our Executive Director Alan Mogridge, please list your name, and email or phone number below. Thank you!

Additional Comments:
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