Protest Evaluation

Standard form #27B/j
Please take a few minutes to fill out this
questionaire. All answers will be kept
confidental and are used only for research
purposes.
1: How did you hear about us?
 __________________________________________
2: Did you enjoy your overall experience?
 ___ Yes ___ No
 If not, why not? _________________________
 ____________________________________________
 ____________________________________________
 ____________________________________________
 ____________________________________________
 ____________________________________________
 ____________________________________________
 ____________________________________________
3: Is this your first protest with this
 (office)? ___ Yes ___ No
4: On a scale of 1 to 10, please rate the
 following aspects of our service:
 (circle one)
Representative access 1 2 3 4 5 6 7 8 9 10
Employee politeness 1 2 3 4 5 6 7 8 9 10
Toilet availability 1 2 3 4 5 6 7 8 9 10
Snacks 1 2 3 4 5 6 7 8 9 10
Parking 1 2 3 4 5 6 7 8 9 10
5: Would you come back and protest again?
 ___ Yes ___ No
6: How can we make future protests more
 fulfilling for you? ______________________
 ____________________________________________
 ____________________________________________
 ____________________________________________
 ____________________________________________
Thank you for your time. Your answers will
help (this office) become more responsive to
protester needs as part of our service goals.