Pre/Post Program Survey
Volunteers, please fill this form out after you have completed the pre or post program survey with your students.
School Name
*
Volunteer Name
*
How many students are present during the survey?
*
Is this a Pre-program or a Post -program?
Pre
Post
Grade Level?
First Grade
Second Grade
Third Grade
Question #1
*
Choice A/E
Choice B/F
Choice C/G
Choice D/H
# of Raised Hands
Question #2
*
Choice A/E
Choice B/F
Choice C/G
Choice D/H
# of Raised Hands
Question #3
*
Choice A/E
Choice B/F
Choice C/G
Choice D/H
# of Raised Hands
Question #4
*
Choice A/E
Choice B/F
Choice C/G
Choice D/H
# of Raised Hands
Question #5
*
Choice A/E
Choice B/F
Choice C/G
Choice D/H
# of Raised Hands
Is there a person at your home that reads to you?
*
Yes
No
Read to at home
Submit
Should be Empty: