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Letters for Change Impact Form
https://crayoncollection.org/events/lettersforchange/
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* Indicates required question
Email
*
Your email
Please provide your first and last name.
*
Your answer
Please provide the best phone number to reach you.
Your answer
I'm a(n)
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Educator
Museum Administrator
Children's Program Coordinator
Parent
Student
Other:
Where are you located? (example: Orlando, Florida)
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Your answer
When did you facilitate this curriculum / activity?
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MM
/
DD
/
YYYY
What age range were the students participating in this activity / lesson? Select all which apply.
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5-7
8-10
11-13
14-16
17+
Other:
Required
How many students were involved in letter writing?
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Your answer
Did the letters of change get posted and mailed out?
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Yes
No
Other:
What interested you in administering the Letters of Change curriculum?
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Your answer
How would you rate the overall impact of this curriculum with students?
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Low impact
1
2
3
4
5
High impact
How would you rate the students' engagement to Letters of Change?
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Not at all engaged
1
2
3
4
5
Very engaged
Students left this curriculum having a sense they could make an impact in the world by using their voice.
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Strongly disagree
1
2
3
4
5
Strongly agree
Please share the impact you have seen with this curriculum.
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Your answer
Please share any additional feedback you have regarding the curriculum.
Your answer
How did you learn about the Letters for Change Curriculum?
*
Crayon Collection Newsletter
Social Media
Google Search
Nickelodeon Newsletter
News Article
The Kelly Clarkson Show
Other:
Would you like to receive our digital newsletter to stay informed about our work and future curriculum?
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Yes
No
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