2016-2017 Post-Field Trip TEACHER Survey
Thank you for attending an Act One Field Trip. Please return survey to [email protected] or mail to Act One,
910 E. Osborn Road, Suite C, Phoenix, AZ 85014.
1. Teacher First and Last Name: ______________________________________________________________
2. Name of School: _______________________________________________________________________________
3. What grade(s) do you teach? Select all that apply.
Kindergarten
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
10th grade
11th grade
12th grade
4. Which field trip did you attend? _________________________________________________________________
Date of field trip: ______________________________
5. How many students attended the field trip from you class? ________________
6. How many adults (teachers and chaperones) accompanied your class on the field trip? ______________
7. Does your school offer art education programs? Select all that apply.
Band
Chorus
Dance
Visual Art
Drama
My school offers no art education programs.
Other ____________________________________
8. Have you been able to take your students at this school on an arts field trip in the last three years?
Yes
No
Other (please specify) _________________________________________________________________
9. Have you been able to take your students at this school on an arts field trip in the last three years?
1-2 times a year
3-5 times a year
6 or more times a year
10. Please list the arts venues you visit. ________________________________________________________
_________________________________________________________________________________________
2016-2017 Post-Field Trip Teacher Survey—Page 2
11. Were you able to integrate the Act One education materials or arts organization’s study guide into
your curriculum or a lesson plan?
Yes, I sued the Act One materials
Yes, I used the arts organization’s study guide
No
12. What other tools, if any, did you use to prepare for the field trip besides what Act One provided?
________________________________________________________________________________________
________________________________________________________________________________________
13. Was this experience age appropriate for your students?
Yes
No—Why not? ______________________________________________________________________
14. The length of the performance was:
Too long
Too short
Perfect
Other ______________________________________________
15. Would you participate in another Act One program in the future?
Yes
No
16. Why or why not? ____________________________________________________________________________
________________________________________________________________________________________________
17. Do you have any suggestions for future programming you would like to see that ties to your
curriculum? ____________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
18. Is there any additional information you would like to provide to improve your and your students’
experience? _____________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
19. If you are aware of how one or more of your students benefited from the experience, please describe.
Include their gender and age. ________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
Please use additional paper if you answers don’t fit on this form.