Compliments Survey
RequiredRequired Question(s)
Required 1.

How did you hear about us?

Internet Search
Advertisement
Friend
Other  
Required 2.

What is your age?

18 - 25 years
26 - 35 years
36 - 45 years
46 - 59 years
60 - 69 years
70+ years
Youth 9-12 years (Parent/Guardian)
Youth 13-17 years (Parent/Guardian)
Prefer Not to Disclose
Required 3.
What class did you take?
 

50 characters left.
4.

Where did you take the class?

 

50 characters left.
Required 5.
What date(s) was teh class or class series?
 

50 characters left.
Required 6.

What was your reason for taking the class?

 

50 characters left.
Required 7.

Who was your Instructor/Coach/Trainer?

Andrea "Andy" Stewart Roa
Cynthia Cubas
Silvia Jimenez
Karen Rocha
Other  
Required 8.

Please rate your Instructor/Coach. 

 Excellent Very Good Satisfactory Not Good Below Expectations No Opinion 
Professional and courteous
Well-Prepared
Encouraging/ Motivational
Attentive
Patient
Fun, Smiles, Laughs
Engaging/ Outgoing
Knowledgeable
  • Comment:

  • 500 characters left.
Required 9.
Please enter the information indicated below.

First Name:
Email Address:
emailaddress@xyz.com
City:
Postal Code:

10.

Any additional comments?

 

1000 characters left.