*	Your Name:
*	Your School's Name:
	Date of Visit	Month Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Day 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Year 2003 2004 2005 2006 2007
	Are you a Fort Discovery Member?	Yes   No

How may we BEST get information to you?
	Making a choice  in this column -	- does not require additional information disclosure in this column
Email:	Home   School
U.S. Mail:	Home   School
		State AL AK AS AR AZ CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY
Phone:	Home   School	( )
School District:	Pony System Other

1=Unsatisfactory  |  2=Needs improvement  |  3=Average  |  4=Good  |  5=Excellent
1. Planning materials for visit	1	2	3	4	5
2. Letter to school	1	2	3	4	5
3. Fort Discovery visit scheduling	1	2	3	4	5
4. Value for price	1	2	3	4	5
5. Fort Discovery initial orientation	1	2	3	4	5
6. Fort Discovery staff	1	2	3	4	5
7. Fort Discovery floor plan & directions	1	2	3	4	5
8. Fort Discovery cleanliness	1	2	3	4	5
9. Fort Discovery exhibits	1	2	3	4	5
10. Overall Fort Discovery visit	1	2	3	4	5

1=Unsatisfactory  |  2=Needs improvement  |  3=Average  |  4=Good  |  5=Excellent
1.Traveling Exhibits (Knox Gallery)	1	2	3	4	5
2. KidScape: young visitor's room	1	2	3	4	5
3. PowerStation: science demonstration	1	2	3	4	5
4. Theatre Program	1	2	3	4	5
5. StarLab (planetarium)	1	2	3	4	5
6. Discovery Lab Programs	1	2	3	4	5
7. Food quality in Discovery Deli	1	2	3	4	5
8. Service in Discovery Deli	1	2	3	4	5
9. Science Store	1	2	3	4	5

                Yes    No          

Please rate only the items that apply.

1=Unsatisfactory  |  2=Needs improvement  |  3=Average  |  4=Good  |  5=Excellent
1. Previous visit	1	2	3	4	5
2. Birthday Parties	1	2	3	4	5
3. Camp-Ins	1	2	3	4	5
4. Website use at home	1	2	3	4	5
5. Website use in your classroom	1	2	3	4	5
6. Science-to-Go School Programs	1	2	3	4	5
7. Summer Camps	1	2	3	4	5
8. Mobile Discovery Centers	1	2	3	4	5
9. Distance Learning	1	2	3	4	5
10. StarLab Training	1	2	3	4	5
11. The Georgia Technology Center	1	2	3	4	5
12. JASON	1	2	3	4	5
13. JROTC Science & Math materials	1	2	3	4	5
14. Other	1	2	3	4	5

1.  Have you taken advantage of any of our Marketing Promotions?

Yes   No

2.  Where have you heard about us?  Please check all that apply.
Newspapers	Radio	TV	Billboards	Special Promotions
Friends	Children/Students	Other Parents	Other Educators	Internet
Other

3.  Would you recommend us to others?

Yes   No

4.  Other Comments?

How can we at NSC / Fort Discovery help you as a Teacher?
1.  Staff Development      Programs
2.  Website Programs
3.  Obtain Classroom      Instruction      Materials (list)
4.  Improved Pre-visit      Materials (list)
5.  Programs for Gifted      Students (list)
7.  Other (list)