Driving with Selvi Screening Feedback Form
Thanks so much for screening Driving with Selvi! If you could please fill out the following form it will help us better understand the film's community impact.
Email address *
What is your name? *
Your answer
What city are you in? And what organization are you a part of? *
Your answer
Where did you hear about Driving with Selvi? *
What were your goals for these screenings? *
Required
Did you achieve your goals for the screening? *
Did not at all
Exceeded expectations
If this was a fundraiser how much did you raise and for what organization? *
Your answer
How many people attended the event? *
Your answer
Audience Demographics: How many people attended in the following age brackets? Under 18
Your answer
Audience Demographics: 20-30
Your answer
Audience Demographics: 30 - 50
Your answer
Audience Demographics: 50+
Your answer
Audience Demographics: Approx How many were male attendees? How many were female attendees? Gender Neutral? *
Your answer
If you organized a post screening panel please tell us who was on it? What issues were brought up? What kind of involvement was there from the audience? *
Your answer
Please rate the general audience reaction/reception *
Not well received at all
Very well received
Did you develop any partnerships through the screenings? *
Your answer
How was your experience as a host? Did you find the community screening toolkit helpful? Is there anything we can do better? *
Your answer
Could you please provide a quote you would be happy for us to use in the future? *
Your answer
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