Evaluation Form

All responses will remain confidential.

Program Name

Dates

Time

Instructor(s)

How did you find out about this program?

Brochure Newspaper Word of Mouth Other

If other, please specify

Please rate your overall level of satisfaction with each area.

1: Very Satisfied. 2: Satisfied. 3: Dissatisfied. 4: Very Dissatisfied.

Enjoyment of Class 1 2 3 4

Program Location 1 2 3 4

Program Equipment 1 2 3 4

Program Fees 1 2 3 4

Program Instructor(s) 1 2 3 4

Knowledge of Instructor(s) 1 2 3 4

Program Days 1 2 3 4

Program Times 1 2 3 4

Would you enroll yourself/your child in this program again?

Yes Unsure No

If no, please tell us why?

Would you recommend this program to a friend?

Yes Unsure No

If no, please tell us why?

Please feel free to make any comments or suggestions.

Name (optional)

Phone (optional)

Enter the code

Washington Park District
105 S. Spruce St.
Washington, IL 61571
(309) 444-9413