Inner Beauty Parent Survey

Inner Beauty Parent Survey
Name

First Name Last Name
Email
example@example.com
The overall program

ExcellentGoodFairPoor
Assigned Life-coach

ExcellentGoodFairPoor
The mission statement

ExcellentGoodFairPoor
Difference you see in yourself since attending Inner Beauty

ExcellentGoodFairPoor
Feedback you receive from the Life-Coach

ExcellentGoodFairPoor
Clarity of expectations about how you should behave while in the program

ExcellentGoodFairPoor
Activities the program offers

ExcellentGoodFairPoor
Communication between you and your mentor

ExcellentGoodFairPoor
Parent(s) opportunity to get involved

ExcellentGoodFairPoor
Parent Support

ExcellentGoodFairPoor
The Inner Beauty Pageant

ExcellentGoodFairPoor
Parent Meetings

ExcellentGoodFairPoor
Child’s views about the program

ExcellentGoodFairPoor
Child’s willingness to participate

ExcellentGoodFairPoor
Parent(s) intentions to continue the program.

ExcellentGoodFairPoor
16). What do you like best about Inner Beauty?
17). What improvements would you like to see?
18). Additional Comments
I CERTIFY THAT I HAVE READ THIS DOCUMENT, AND I FULLY UNDERSTAND ITS CONTENT. I AM AWARE THAT THIS ISA RELEASE OF LIABILITY AND A CONTRACT AND ISIGN OF MY OWN FREE WILL.
(Child's Name)
(Parent/Guardian's Signature)

Clear
(Parent/Guardian's Printed Name)
(Date)

MonthDay Year
Date
Should be Empty: