1. Grade Level(s)  

Number of students

2.     What did you like about the packet?

 3.     What didn’t you like about the packet?

4.     Were there activities in the packet that were appropriate for your students?

Yes No Not sure

5.     If you used activities, which ones did you use?

6.     Did you access cleanup data on our web site? If so, for what?

7.     Any other comments/suggestions for improvement?

8.     Would you like us to contact you about booking a field trip or educational presentation? If so, please fill out the information below: 

Name Phone  

E-mail address

School

Street address

City, State Zip

Number of students or classes

Grade level(s)

I am interested in (check all that apply):

Beach Cleanup 

Tide Pool Excursion

Day at the Beach Field Trip (select activities below; to select multiple activities hold down the Ctrl key while you click):

Beach Cleanup Tide Pool Excursion Related Games Research Activity Other/Not Sure

Program at my Site

     Pollution Solutions Inflatable Whale Traveling Tidepools Combination/Other        

Desired Date(s):

Desired Time(s):

Any site preference?

Will you be studying related material prior to your visit? If so, what?