Musical Performance Feedback Form
Please complete this form for each Creative Aging Mid-South musical performance held at your facility.

* indicates required fields 
  *Facility Name::
  *Performers' Name(s)::
  *Perfomance date:
  *Perfomance time:
  *Total # of people attending:
  *Number of people who are 65+ years old:
  *Number of men in audience who are 65+ years old:
  *Please rate the overall performance:
  *Please rate artists' interaction with the audience:  1 -- There was none
 2 -- Some after the performance
 3 -- Some during the performance
 4 -- Some during and after the performance
  *Did the artist contact you before the performance?:  Yes
 No
  *Was the music too soft or too loud?:  too soft
 just right
 too loud
  *Will schedule these performers again?:  Never
 Possibly
 Definitely
 Anytime I can
  What did you like about the performance?:
  Comments:

Thank you for completing this form. We use your feedback to ensure that we continue presenting artists that our audiences enjoy.
 

with support from:


The H. W. Durham Foundation

  

   

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200 Jefferson Ave. Ste. 707     Memphis, TN  38103     (ph) 901.272.3434     (fax) 901.274.8369     creativeaging@bellsouth.net


Creative Aging Mid-South is tax-exempt 
under section 501(c)(3) of the Internal Revenue Code.

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