Program Feedback Form

Thank you for taking the time to provide your feedback on our programs. We appreciate your input into the WISE Mobile Active Living Centre.

Which program did you attend? (please note you can select one program per form)

Please name or specify the program topic, workshop, or special event you attended

Please provide the location or town of the program

What was your overall level of satisfaction with the program?

Very satisfied

Satisfied

Neutral

Somewhat satisfied

Not satisfied

The program was informative, educational and relevant to the topic

Strongly Agree

Agree

Neutral

Disagree

Strongly Disagree

The program offered enough time to cover the topic, information or physical activity

Strongly Agree

Agree

Neutral

Disagree

Strongly Disagree

The facilitator was thorough at covering the topic, information or physical activity

Strongly Agree

Agree

Neutral

Disagree

Strongly Disagree

Feedback/Comments

I consent to my feedback, comments, or quotes to be used for marketing purposes such as newsletters, media releases, and/or articles for publication. Please provide your name in the feedback section as this form is anonymous.

I consent

I do not consent

Today's Date

This information is collected in a safe and secure manner and is collected in accordance with s.29(2) of the Municipal Freedom of Information and Protection of Privacy Act.

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Program Feedback Form