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RA Program Evaluation

Click here for the printable PDF version of this form.

( This form must be filled out within 48 hours of the completion of the program. Please note that
Yes/No/Okay are not acceptable answers.)




RA Name(s):
E-mail:
Today's Date:
Program Title:

Type of Program:
Emotional Intellectual Physical Service Social Spiritual
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Was the program sucessful?
Very Successful
Successfull
Fair
Unsuccessful
Why?
What type of information/handouts did you give to resisdents?
How can the program be improved?
How did the residents respond to the program?
How did this program affect your community ?

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Total Attendance:
Would you recommend this program?
Yes
No
Signature:
Supervisor Signature :
 

Who of the following people need to receive this form?
Karolina Dreher
David Stuart
Rory Deegan
Andy Bright
Stacey Scherer

 



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