Ambassador Feedback Form

Program Date*

Program / Artist(s)

Please rate the overall program by selecting the appropriate number, using the following scale.

1 (Poor)
2
3
4
5 (So-So)
6
7
8
9
10 (Excellent)

The artist interacted with the audience (check all that apply):

Before the performance
During the performance
After the performance

Please share a comment from the audience or special story that happened during the performance.

Name*
Program Date*
Community
Program / Artist(s)
Approximate number in the audience
Please rate the overall program by selecting the appropriate number, using the following scale.	1 (Poor) 2 3 4 5 (So-So) 6 7 8 9 10 (Excellent)
The performance was (check all that apply) :	Outstanding Uplifting Enjoyable Engaging Mediocre Too mellow Inappropriate
The artist interacted with the audience (check all that apply):	Before the performance During the performance After the performance
Taking into consideration the overall health of the audience, the audience's level of engagement with the artist / performance was (check all that apply):	Somewhat engaged Engaged Very engaged
Please share a comment from the audience or special story that happened during the performance.
Do you have any suggestions to improve the program / performance or Creative Aging Services?

Enriching Lives Through the Arts