Inner Beauty Client Survey

Inner Beauty Client Survey
Name

First NameLast 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
Thursday meetings

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
College tours

ExcellentGoodFairPoor
Parent Support

ExcellentGoodFairPoor
The Inner Beauty Pageant

ExcellentGoodFairPoor
Accessibility to your mentor

ExcellentGoodFairPoor
Possibility of referring a friend

ExcellentGoodFairPoor
Your willingness to participate

ExcellentGoodFairPoor
Intentions to continue the program

ExcellentGoodFairPoor
16). What do you like 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)

MonthDayYear
Date
Should be Empty: