Program Data Sheet Contact InformationFirst Name* Last Name* Email* Phone Facility InformationActivity Director* Facility Name* Program Name* Program Date* MM slash DD slash YYYY Program Start Time* : Hours Minutes AM PM AM/PM Program End Time* : Hours Minutes AM PM AM/PM Program EvaluationTotal number in attendance (all ages)*Total number of seniors in attendance (55 &older)*Total children in attendance (less than 18 years old)*Did the majority of the participants enjoy this program?* Yes No Would you recommend this performance to a facility similar to yours?* Yes No How would you rate this program?* Excellent Good Fair Poor If you rated Fair or Poor, please explain or advise how the show could be improved.Do you have recommendations to improve this performance?NameThis field is for validation purposes and should be left unchanged.
