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Home > Educational Outreach > Outreach Programs > Mobile Discovery Centers > Post-Visit Survey

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The National Science Center (NSC) is a partnership between the United States Army and a non-profit corporation, NSC, Inc.  We value your input for this program.

Site Information
Start Date:*		* Click select for date.
End Date:*		* Click select for date.
Name(s) of MDC demonstrators:
Your Name:*
Your Position:*
School Name:*
School District:
City:*
State:*		select... Alabama Alaska Arizona Arkansas California Colorado Connecticut District of Columbia Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Zip/Postal Code:*
Phone Number:*
Email Address:*
May we contact you?		Yes No
Please rate any of the following items that apply. Ratings are as follows: 1=Unsatisfactory; 2=Needs Improvement; 3=Satisfactory; 4=Very Good; 5=Excellent
Program Information
1. Scheduling the program		12345
2. Quality of the MDC facility		12345
3. Website's program description		12345
4. Scheduling the visit		12345 12345
5. Quality of demonstration equipment		12345
Content
1. Demonstration concepts met		12345
2. Appropriate vocabulary level		12345
3. Safety objectives Met		12345
4. Use of demonstration equipment		12345
5. Curriculum compatibility met (K-12)		12345
Demonstrator
1. Welcome		12345
2. Rapport		12345
3. Appearance		12345
4. Enthusiasm		12345
5. Knowledge of subject matter		12345
Students
1. Involvement in program		12345
2. Reaction to this program		12345
3. Overall program value		12345
For 6th - 9th Grade Classes Only
1.	How interested are your 6th-9th grade students in the eCYBERMISSION program (online science project) that the MDC team talked about? 1=NONE; 2=A FEW; 3=SOME; 4=MANY; 5=MOST of my 6th-9th grade students are interested.	12345
2.	How likely is your school to implement the eCYBERMISSION Program? 1=Will not implement; 2=Not likely;  3=Somewhat likely; 4=Likely; 5=Very Likely	12345
Other Comments: (Suggestions, ideas for new programs, NSC information requests, etc.)
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