WILDFIRE PREVENTION PROGRAM EVALUATION We would appreciate it if you would take a few moments to fill out this evaluation sheet and return it within five days to: {Name, Agency and Address} Thank You.
Question	Response		Comments
1. What is the age and grade level of your students?	Age Grade
2. Is the lesson appropriate and/or effective for this age and grade level?	Yes	No
3. How many students are in your group?
4. Do you feel that your students understand the concepts that were presented?	Yes	No
5. Was the lesson plan delivered in a manner that was easy for your students to understand?	Yes	No
6. What was YOUR response to the program? Please score using a scale of 1 to 5 where 1 = poor and 5 = excellent.	Score
7. What was your students' response to the program?	Score
8. Would you be interested in having our agency visit your school again?	Yes	No
9. Name of your preschool or school:
10. Address of your school:	Street:
	City                     Zip
11. Your name:
12. School phone number: (   )
We are looking forward to the response about our program from you and your students. We value your opinion, and your comments will help us to continue improving our wildlife prevention program. Please return this form within the next five days. Thank you for participating in this evaluation. We appreciate it!
Your comments on the overall program will be appreciated. (Use additional sheets of paper if needed)