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Name of Program:__________________________________________________________Date:______________
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How did you find out about this program? (check all that apply)
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_____Newspaper
_____Social media (Facebook, etc.)
_____Radio
_____From a friend/associate
_____Television
_____Public/group announcement
_____Postcard or brochure (mailed)
_____Website
_____Calendar of Events (mailed)
_____Poster
_____Email
_____Other (please specify)
Reason for attendance
_____ I am a member/friend of the National Archives or sponsoring organization
_____ I am interested in the subject
_____ I came with a friend
_____ Other (please specify) ______________________________________
Is this the first National Archives program you’ve attended? ____Yes ____No
Did this program enhance your understanding of the topic? _____Yes _____No
Overall, how would you rate your satisfaction with this program?
Highly Successful ____5 ____4 ____3 ____2 ____1 Least Successful
Have you visited the National Archives exhibitions today or ever? ____ Yes ____No
Will you visit them after this program? ____Yes ____No
Additional Comments? __________________________________________________________________________________
_________________________________________________________________________________________________________
If you’d like to receive future program information, please fill out the following:
Name: __________________________________________________________________________________________________
Email: __________________________________________________________________________________________________
Mailing Address: (if you wish to receive our program information by mail)___________________________________
_________________________________________________________________________________________________________
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If you wish to direct additional comments to a supervisor, you may contact
PAPERWORK REDUCTION ACT PUBLIC BURDEN STATEMENT: You are not required to provide the information requested on a form that is subject to the Paperwork Reduction Act unless the form displays
a valid OMB control number. Public burden reporting for this collection of information is estimated to be less than 5 minutes per response. Send comments regarding the burden estimate or any other
aspect of the collection of information, including suggestions for reducing this burden, to National Archives and Records Administration (I-P), 8601 Adelphi Rd, College Park, MD 20740-6001. DO NOT SEND
COMPLETED FORMS TO THIS ADDRESS.
OMB Control No. 3095-0023 Expiration date 12/31/2016
NA Form 2019 [18] (05-12)
File Type | application/pdf |
File Title | NARA Genearl Feedback form |
Subject | NARA Genearl Feedback form, Genearl Feedback form |
Author | NARA |
File Modified | 2014-05-28 |
File Created | 2014-05-27 |