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? *
What city are you in? And what organization are you a part of? *
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? *
How many people attended the event? *
Audience Demographics: How many people attended in the following age brackets? Under 18
Audience Demographics: 20-30
Audience Demographics: 30 - 50
Audience Demographics: 50+
Audience Demographics: Approx How many were male attendees? How many were female attendees? Gender Neutral? *
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? *
Please rate the general audience reaction/reception *
Not well received at all
Very well received
Did you develop any partnerships through the screenings? *
How was your experience as a host? Did you find the community screening toolkit helpful? Is there anything we can do better? *
Could you please provide a quote you would be happy for us to use in the future? *
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google.