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About
Creative Aging
Aging and the Arts
Leadership
Press
Supporters
Connect
Arts Programs
Performances & Workshops in Senior Communities
Artists and Musicians
Audiences We Serve
Program Evaluation Form
Senior Art Series
Senior Studio Courses
Get Involved
Work as a Creative Aging Artist
Opportunities for Seniors
Senior Communities
Volunteer
Volunteer Interest Form
Ambassador Feedback Form
Connect
Attend an Event
Senior Art Series
Calendar
Photo Gallery
Contact Us
Donate
Ambassador Feedback Form
1
2
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?
Please answer the simple math question below to submit the form.
2 + 2 =
We're sorry, your answer was incorrect. This math question has been inserted to reduce the amount of spam we receive from web bots. The correct answer is 4, if you'd like to try again."
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