Form 1 Creative Forces Event Feedback Survey

ATTACHMENT B
CREATIVE FORCES EVENT FEEDBACK SURVEY
FINAL – JANUARY 10, 2022
Thank you for attending this event supported by a Creative Forces Community Engagement grant. This
grant program, supported by the National Endowment for the Arts in cooperation with the Mid-America
Arts Alliance, aims to improve the health, well-being, and quality of life for military service members and
veterans as well as their families and caregivers.
This brief survey will collect your feedback about your experiences attending this event. Your responses
will remain anonymous and will be used only to report on the effectiveness of current programming and
to improve future programs. Your responses will not be associated with, nor have any influence on, your
relationship with the program provider, Mid-America Arts Alliance, or the National Endowment for the
Arts.
Your participation is voluntary. You will not receive any compensation for responding to the survey. You
may decline to answer any questions you wish. Under the Paperwork Reduction Act of 1995, no persons
are required to respond to a collection of information unless such collection displays a valid Office of
Management and Budget (OMB) control number. The OMB control number for this survey is OMB No.
XXXX-XXXX (expires XX/XX/XXXX). The time required to provide responses to the survey questions is
estimated to be approximately 5 minutes. Please contact the Mid-America Arts Alliance at
[email protected] or the National Endowment for the Arts at [email protected] if you have any
questions regarding the estimated time burden or any other aspect of this data collection.
Click here to begin.
[Page break]
1. How did you hear about this program/event? [Select all that apply]
o
o
o
o
o
o
o
o
o
o
o

Website
Printed brochure or flyer
Email promotion
Facebook
Twitter
Newspaper story or announcement
Radio announcement
Internet search
I was involved in another program/event with this organization
Someone I know told me about it
Other (please specify)
Not at All
Engaged
1

A Little
Engaged

Mostly
Engaged

Very
Engaged

2. How engaged did you feel during this
program/event?

3. How likely are you to attend or
participate in another program/event
with us?
4. How likely are you to recommend it to a
friend, family member, or colleague?

Very
Unlikely

Somewhat Somewhat
Unlikely
Likely

Very
Likely

5. Have you participated in or attended other programs here, either now or in the past?
o
o
o

Yes
No
Unsure
If yes, please name or briefly describe the program(s): [300 character limit]

6. This is my first experience with an event combining the arts and the military.
o
o
o

Yes
No
Unsure

7. My understanding of the arts has changed as
a result of this activity.

Strongly
It’s
Disagree
Agree
disagree
mixed

Strongly
agree

Items 8 and 9 are optional for grantees to add, depending on their goals and what they wish to
measure.
8. My understanding of the experiences of
veterans or people who serve in the military
has changed as a result of this activity.
9. I am interested in learning more about
military experiences or culture as a result of
this activity.
10. Do you have any suggestions/comments that will help us make the program/event better?
[300 character limit]

Optional: Please tell us a little about yourself. This information will help us understand who attended
the program and whether there are changes we can make to ensure it is worthwhile to everyone.
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11. Which best describes you? (check all that apply)

o Service Member

o Veteran

o
o
o

Active Duty
National Guard
Reserve

o

Retiree

o Spouse/Partner of a Service Member or Veteran

o

o
o
o
o
o

o Active Duty Service Member
o National Guard/Reserve
o Veteran
Other Family Member of a Service Member or Veteran
o Active Duty
o National Guard/Reserve
o Veteran
Caregiver for a
o Service Member
o Veteran
Health care worker serving military-connected populations
Civilian
Other ________
Prefer not to say

12. What is your age?

o
o
o
o

0 – 17 years
18 – 24 years
25 – 64 years
65+ years

13. Which best describes you? (check all that apply)

o
o
o
o
o
o
o
o

American Indian or Alaska Native
Asian
Black or African American
Hispanic or Latino
Native Hawaiian or Other Pacific Islander
White
Other Racial/Ethnic Group
Prefer not to say

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