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Evaluation Form – 2019

SHAKEmob
Challenge

Evaluation Form – 2019

    Please answer the following questions

    1. Overall, how would you rate the #SHAKEmob Challenge?

    ExcellentVery goodGoodFairPoor

    2. How helpful to you were the instructional materials for motivating students to become more prepared for earthquakes?

    Not at all helpfulSomewhat helpfulVery helpfulExtremely helpful
    Not at all helpfulSomewhat helpfulVery helpfulExtremely helpful
    Not at all helpfulSomewhat helpfulVery helpfulExtremely helpful

    3. Students found the Rocket Rules Earthquake Safety video...

    Disagree very muchDisagree somewhatAgree somewhatAgree very much
    Disagree very muchDisagree somewhatAgree somewhatAgree very much
    Disagree very muchDisagree somewhatAgree somewhatAgree very much
    Disagree very muchDisagree somewhatAgree somewhatAgree very much
    Disagree very muchDisagree somewhatAgree somewhatAgree very much

    4. Students found the #SHAKEmob dance activity...

    Disagree very muchDisagree somewhatAgree somewhatAgree very much
    Disagree very muchDisagree somewhatAgree somewhatAgree very much
    Disagree very muchDisagree somewhatAgree somewhatAgree very much
    Disagree very muchDisagree somewhatAgree somewhatAgree very much
    Disagree very muchDisagree somewhatAgree somewhatAgree very much
    Disagree very muchDisagree somewhatAgree somewhatAgree very much

    5. Students found the #SHAKEmob song...

    Disagree very muchDisagree somewhatAgree somewhatAgree very much
    Disagree very muchDisagree somewhatAgree somewhatAgree very much
    Disagree very muchDisagree somewhatAgree somewhatAgree very much
    Disagree very muchDisagree somewhatAgree somewhatAgree very much
    Disagree very muchDisagree somewhatAgree somewhatAgree very much
    Disagree very muchDisagree somewhatAgree somewhatAgree very much

    6. After completing the three activities, students...

    Disagree very muchDisagree somewhatAgree somewhatAgree very much
    Disagree very muchDisagree somewhatAgree somewhatAgree very much
    Disagree very muchDisagree somewhatAgree somewhatAgree very much
    Disagree very muchDisagree somewhatAgree somewhatAgree very much
    Disagree very muchDisagree somewhatAgree somewhatAgree very much

    7. How likely is it that you will recommend the #SHAKEmob Challenge to others?

    12345678910

    8. What were the most useful aspects of the #SHAKEmob Challenge?

    9. How could we improve the #SHAKEmob Challenge?

    10. Is there anything else you'd like to share about the #SHAKEmob Challenge?

    11. Did your students participate during or after school hours?

    During school hoursAfter school hoursBoth during and after school hours

    12. What is the grade level of your students who participated in the #SHAKEmob Challenge? (Check all that apply)

    Kindergarten1st grade2nd grade3rd grade4th grade5th gradeOther (please specify below)

    13. How many children participated in the challenge?

    14. What activities did your students participate in? (Check all that apply.)

    Watched the Rocket Rules Earthquake Safety VideoParticipated in the 2019 Great ShakeOutPerformed the #SHAKEmob DanceCreated a #SHAKEmob Dance videoActivity 1: Emergency Safety KitActivity 2: Emergency ContactsActivity 3: Understanding how Long Earthquakes LastNONE- We did not participateOther (please specify below)

    Now we have a few questions about how to contact your program administrator.

    15. What is the name of the contact person for your school or after-school program?

    16. What is the name of your school or after-school program?

    17. What is this person's role?

    PrincipalAssistant PrincipalTeacherSite supervisorOther (please specify below)

    18. What is your school or after-school program mailing address?

    Thank you very much for your participation!