Neighborhood Bike Works Program Evaluation

Program Completed:
My child identifies their gender as:
My child identifies their race/ethnicity as (check all that apply):

Please answer the questions about your child’s experience from your perspective.  This survey lets us know what we are doing well and what we can improve. Please be completely honest. You do not need to write your name on this form.

INSTRUCTIONS: Select your rating for each statement. Each number of stars represents your answer ranging from “no” (1 star), “mostly no” (2 stars), “somewhat” (3 stars), “mostly yes” (4 stars), and “yes” (5 stars).

INSTRUCTIONS: Answer the statements below with complete sentences. This information is very helpful to us in knowing more about your experience. There are no right or wrong answers Please provide as much information as you would like.