All information gathered by this questionnaire is for development purposes. The information you provide will help us to continue to improve the STARBASE program. Please provide honest feedback about various issues presented in this questionnaire. We are collecting information from all of the STARBASE programs.
Completed questionnaires will be tallied by an agency outside of your school and outside of STARBASE. Individual responses will be strictly confidential and will not be released to your school or to any STARBASE representative.
This questionnaire contains a total of 41 questions and should take less than 15 minutes to complete. If you have any questions about this survey, please call 1-312-242-4378.
Thank you
Please enter in today's date
(mm/dd/yyyy)
Please enter the name of your school
What is your school's address?
What is the name of your principal or contact person?
Other
With what STARBASE location do you work?
Other