Team Evaluation Form

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Staff Name:_____________________Contact Number:571-243-2119
Name/Adress____________________________________________
PLEASE CIRCLE APPROPRIATE RESPONSE
Strongly
Strongly Does Not
Agree
Agree
Disagree
Disagree Apply
1.
Was staff courteous?
4
3
2
1
0
2.
Was the Moon Bounce Clean and
Attractive?
4
3
2
1
0
3.
Was the program well-organized?
4
3
2
1
0
4.
Did your moon bounce arrive on time?
4
3
2
1
0
5.
Were the activities interesting?
4
3
2
1
0
6.
Were program staff prepared and
organized?
4
3
2
1
0
7.
Did the program meet the advertised
goals and objectives?
4
3
2
1
0
8.
Would you request T.E.A.M again?
4
3
2
1
0
9.
What other activities would you like us to provide?(i.e. Table, Chairs, Snow Cone Machine)
10. Overall, HOW SATISFIED ARE YOU WITH THE PROGRAM?
_____ Very satisfied
_____ Somewhat dissatisfied
_____ Somewhat satisfied
_____ Very dissatisfied
_____ Undecided
Comments:
11. How did you hear about this program. Check one or any that apply?
_____ Mailed brochure/flyer
_____ Picked up info at center
_____ Flyer/poster
_____ Friends/neighbors
_____ P.R..C.R
_____ Referral
_____ Parks
_____ Called Facility
_____ Other
Thank You for your time and comments!
Signature:_____________________________________
PLEASE SEND THIS FORM TO
ND
3501 S 2
ST ARLINGTON VA, 22204
OR
FAX TO 703-228-5926
WITH ATTENTION TO ANTOINE E SYMNS

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