Form Fs-GT-1600-2 Grey Towers Conservation Education Program Evaluation

Grey Towers Conservation Education
Program Evaluation
GT-FS-1600-0002 (REV. 02/2013)
OMB #0596-0226 Exp. 07/2014

Ref FSM 1620

GREY TOWERS
At Grey Towers National Historic Site, we strive to provide
quality curriculum-based programs. As a program participant,
your input is vital. Please take a few moments and fill out this
form so that we may better serve you in the future. Thank you!

Program Title:
Program Date:
Your Name:
Name of Participating School:
Location of Participating School:
Grade Level:

Number in Attendance:

Number of Children:

Number of Adults:

Did the program meet your expectations and fulfill your curriculum needs? Why or why not?

In what way[s] can this program be improved?

Would you recommend a Conservation Education program at Grey Towers to a colleague? Why or why not?

Privacy Act Statement

Thank you for your interest in the Conservation Education Program at Grey
Towers National Historic Site. If you have any further needs please feel free
to contact us at (570) 296-9630.
According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to a collection of
information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0596-0226. The time required to
complete this information collection is estimated to average 5 minutes per response, including the time for reviewing instructions, searching existing data
sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.
File Code: 1620

Page 1 of 1