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Educational Program
Customer Service Survey
URL
This field is for validation purposes and should be left unchanged.
Name and location of event
(Required)
Date of Program
MM slash DD slash YYYY
Time of Program
Hours
:
Minutes
AM
PM
AM/PM
Address
Street Address
City
ZIP / Postal Code
Number in Attendance
What were the approximate ages of those attending this program?
How was the length of the program?
(Required)
Appropriate
Too long
Too short
Did you feel confident and comfortable with the presenter(s)?
(Required)
Yes
No
Was the program/presentation a positive experience?
(Required)
Yes
No
Would you contact our department again in the future for programs/presentations?
(Required)
Yes
No
Do you have any comments or suggestions for improving our service in the future?
Would you like to be contacted about this survey?
Yes
No
Name
(Required)
First
Last
Email
(Required)
Phone
(Required)
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