Neal Smith National Wildlife Refuge - Public Program Feedback Form

OMB Control No. 1090-0011
Expires 08/31/2018

Neal Smith National Wildlife Refuge-Public Program Satisfaction Survey

This survey will ask questions about the program you attended. Please answer all
questions with as much detail as possible. Your feedback helps us improve our public
programs. Thank you!

Which program did you attend?

Please write the date you attended the program

How did you hear about this program?
Friend/Family
Newspaper
Facebook
Email
Other (please explain)

Overall, did the program meet your expectations?
Yes
No

Please rate the quality of the program
Very Poor

Poor

Average/ Fair

Good

Very Good

Paperwork Reduction Act Statement: We estimate it will take you 5 minutes to complete the survey, including time to read
instructions, gather information, complete, and submit the assessment. We will use the information to gauge audience satisfaction
with content, and to improve/make changes per audience suggestions. Your response is voluntary. We may not conduct or sponsor
and you are not required to respond to a collection of information unless it displays a currently valid OMB Control Number. You may
submit comments on any aspect of this information collection to the Information Collection Clearance Officer, U.S. Fish and Wildlife
Service, 5275 Leesburg Pike, MS: BPHC, Falls Church, VA 22041-3803, or you may submit comments via email at
[email protected].

OMB Control No. 1090-0011
Expires 08/31/2018

What are three things you learned from participating in this program?

What other information would you have liked to see covered in the program?

After today's program, how likely are you to do the following?

Recommend the program to family or a friend
Extremely unlikely Somewhat unlikely Neither likely nor
unlikely

Somewhat likely

Extremely likely

Somewhat likely

Extremely likely

Somewhat likely

Extremely likely

Attend another refuge program
Extremely unlikely Somewhat unlikely Neither likely nor
unlikely

Visit Neal Smith National Wildlife Refuge
Extremely unlikely Somewhat unlikely Neither likely nor
unlikely

Tell a friend or family about Neal Smith National Wildlife Refuge

OMB Control No. 1090-0011
Expires 08/31/2018

Extremely unlikely Somewhat unlikely Neither likely nor
unlikely

List any other comments or questions below

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Somewhat likely

Extremely likely