1) Did your class watch the “Your Ideas
Count” video?
Yes No
1a) If yes, how would you rate the
video overall?
Excellent
Good
Fair
Poor
1b) Was the video appropriate for
this grade level?
Yes
No
1c) Did it help students understand
concepts of representative democracy?
Strongly Agree
Agree
No Opinion
Disagree
Strongly Disagree
2) Did your class receive the “Your
Ideas Count” booklet?
Yes
No
2a) If yes, how would you rate the
booklet overall?
Excellent
Good
Fair
Poor
2b) Was the booklet appropriate for
this grade level?
Yes
No
2c) Did it help students understand
concepts of representative democracy?
Strongly Agree
Agree
No Opinion
Disagree
Strongly Disagree
3) Did you use the online lesson plans
provided by NCSL? (link
to plans)
Yes
No
3a) If yes, how would you rate the
lesson plans overall?
Excellent
Good
Fair
Poor
3b) Were the plans appropriate for
this grade level?
Yes
No
3c) Did the plans complement the
legislators visit?
Yes
No
3d) Did the plans help you prepare
for or follow up on the visit?
Yes
No
4) Did you consult with the legislator
prior to his or her visit to the classroom?
Yes
No
5) The event was held in September.
What would be the best month for next year?
6) How did you learn about Back to
School Week?
7) Did this program meet your
expectations?
Yes
No Please explain:
8) Comments and Suggestions:
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