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BUILDING STRONG FAMILIES PROGRAM FEEDBACK FORM
Please take a moment to fill out the following form about all aspects of your Building Strong Families program activities.
Send in whenever you have impact to report. Thank you!
(NOTE: required responses are marked by *)
Name of person reporting: *
Other team members:
In order to make multiple selections or make changes, please hold the key marked 'Ctrl' while selecting.
I did the following Building Strong Family activity/program:
(check ONE per feedback form)
1. Building Strong Family Management:
News Column or Newsletter
Answered consumer questions
Adult Financial Management
Youth Financial Management
Poverty Simulation (Adult)
Poverty Simulation (Youth)
Money Simulation (EX. Real World/Real Decisions)
Resource Management (Other than financial)
Aging Issues
2. Building Strong Family Relationships:
News column or Newsletter
Answered consumer questions
Parenting Classes
Strengthening Families (Adult)
Strengthening Families (Youth)
Real Color Matrixx (Adult)
Real Color Matrixx (Youth)
Guardianship
Couple Talk
Fatherhood
Aging Issues
3. Building Strong Families & Communities:
News column or Newsletter
Answered consumer questions
Child Care Provider Conference and/or Workshop
Special Events (like Children Festival and Family Night)
Mentoring
Juvenile Diversion
Family doing service in communities
Family Coaliations
Aging Issues
4 (a). Date of Event:
Oct. 1, 2004 - Sept. 30, 2005
Oct. 1, 2005 - Sept. 30, 2006
4 (b). District:
SE
WC
NE
PH
Statewide
5. Approximate number of people reached by this program/activity
(# of articles or newsletters written/submitted):*
To report evaluation summaries and impact, select one of the
following
evaluation forms:
Please select the Evaluation Questions
Nurturing Children
Parenting Children
Interpersonal Relationships
Resource Management
Real Color Matrixx
Generic Questions
BSF Curriculum (from MO)
Guardianship
Helping Children Resolve Conflict
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