Form Center

2. Red Cross Swimming - Instructor Evaluation Form
4. First Name
   (required to be entered into the draw)
5. Last Name
   (required to be entered into the draw)
7. Phone Number
   (required to be entered into the draw)
8. Email
   (if you would like a response)
12. Instructors Name*
13. Swimming Level *
    -- Select One --StarfishDuckSea TurtleSea OtterSalamanderSun FishCrocodileWhaleLevel 1Level 2Level 3Level 4Level 5Level 6Level 7Level 8Level 9Level 10

    Please indicate the level you child was enrolled in with the instructor you are evaluating.
15. What do you like about the swimming lesson program offered at the NLAC? (Red Cross)*
17. What could improve about our swimming lesson program?*
19. What did you like about the instructors teaching style: *
21. Where could the instructor improve?*
23. Additional Comments or Concerns
27. How satisfied are you with the Red Cross Swim program?*
    -- Select One --Very Satisfied Somewhat Satisfied Neutral Somewhat Unsatisfied Very Unsatisfied

    For this question, please indicate your satisfaction with program, not the instructor.
29. Please explain: *
31. Do you have any suggestions for us?
Leave This Blank:


33. 1. Receive an email copy of this form.
34. Email address

    This field is not part of the form submission.

35. Submit Submit and Print

* indicates a required field