SwISTEM Equipment Lending Service Post Check-Out Evaluation
For future funding possibilities and service upgrades, it is very important that you complete the following brief survey after each equipment check-out period. Thank you for your time.
First Name *
Your answer
Last Name *
Your answer
School or Organization *
Your answer
County *
Your answer
Date of Equipment Check-out *
When was the equipment delivered?
Your answer
Grade Level/Subject Matter *
What grade level and/or subject matter was taught using the equipment? Check all that apply.
Required
Equipment Type *
Please select the type of equipment you checked out from the Equipment Lending Service. Check all that apply.
Required
Student Impact *
Approximately, how many students used the equipment during this check-out period?
Your answer
Reservation Process *
Please rate the reservation process of the equipment.
Very Inconvenient
Very Convenient
Delivery Process *
Please rate the delivery process of the equipment.
Poor
Excellent
Retrieval Process *
Please rate the pick-up process of the equipment.
Poor
Excellent
Equipment Quality *
Please rate the quality of the equipment.
Poor
Excellent
Equipment Availability *
Were you able to reserve the equipment for the date you wished to use it?
Required
Equipment Difficulties
Please indicate any problems or difficulties you encountered with the equipment. (Broken, Damaged, Missing Parts, etc.)
Your answer
Other Comments
Questions, Concerns, Needs, Etc.
Your answer
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