Survey - Sound Off with the Home Fire Safety Patrol

Name (optional)

First Last

School*

School Address*

Street Address City State ZIP Code

Email (optional)

School Phone*

Grade I Teach:*

2nd
3rd

1. Which of the three activities did you use? Check all that apply.

Activity 1: Sound Off with the Home Fire Safety Patrol
Activity 2: Detect the Dangers
Activity 3: Your Home Fire Escape Map
None

2. Were you satisfied with the program's developmental appropriateness for your students? Rate your satisfaction on this scale from 1 (not satisfied) to 5 (very satisfied).

If you were dissatisfied, please explain WHY.

3. Were you satisfied with the program's reading level for your students? Rate your satisfaction on this scale from 1 (not satisfied) to 5 (very satisfied).

If you were dissatisfied, please explain WHY.

4. Please rate the following aspects of the program on a scale of 1 to 5, with 5 being the highest rating.

Visit by firefighters

In-class learning

At-home learning

How do you think your students would rate these aspects of the program on the same 1 to 5 scale?

Visit by firefighters

In-class learning

At-home learning

Please suggest changes you would recommend for these aspects of the program.

5. How did families participate in the program? Check all that apply.

Completed at-home portions of printed materials.
Requested more smoke alarm information.
Did not participate.

If families did not participate, WHY?

6. Are there other improvements you recommend for the program?

Survey – Sound Off with the Home Fire Safety Patrol