Program Survey
Program Date:
Location:
Title:
Presenter:
Program Quality?
Very Satisfied
Satisfied
Neutral
Dissatisfied
Very Dissatisfied
Program Content?
Very Satisfied
Satisfied
Neutral
Dissatisfied
Very Dissatisfied
Presentation of Program?
Very Satisfied
Satisfied
Neutral
Dissatisfied
Very Dissatisfied
Price/Benifit (value of cost)?
Very Satisfied
Satisfied
Neutral
Dissatisfied
Very Dissatisfied
Comments:
What did you like most/least in the program?
Would you recommend us to a friend?
New/Different program suggestions?
Additional comments?
Name/Phone# (optional)
Please tell us your e-mail address (optional)