Parent Evaluation Form

Please fill out the following evaluation on your daughter after she attends Essentials 4 Your Life program. Please circle the appropriate response for each question below. Your feedback is vital to the success of this program to better prepare girls in making healthier lifestyle choices. Thank you for letting us teach your daughter overall self-improvement by her participating in the Essentials 4 Your Life program. We hope that this program has surpassed you and your daughter’s expectations. We thank you for your valuable time and greatly appreciate your feedback.

  1. Before your daughter attended Essentials 4 Your Life’s program, her self-confidence was:
    Extremely PoorPoorAverageAbove AverageHigh
  2. After my daughter completed the Essentials 4 Your Life program, her self-confidence has:
    DeclinedStayed the sameImprovedGreatly Improved
  3. My daughter’s personal care regimen has:
    DeclinedStayed the sameImproved
  4. My daughter’s overall health and nutrition has:
    DeclinedStayed the sameImproved
  5. My daughter’s overall etiquette has:
    DeclinedStayed the sameImproved
  6. My daughter’s relationships are:
    DecliningNo changeImprovingMuch healthier
  7. Have you seen any improvements in your daughter’s success at school for example, better study habits, grades improving or improved attendance?
    No improvementVery littleImprovingMajor improvement
  8. Have you seen a decrease in any problem behaviors your daughter may have had prior to taking Essential 4 Life’s program?
    YesNoNo problem behaviors
  9. Have you seen an overall improvement in your daughter?
    No improvementVery littleImprovingMajor improvement
  10. How likely are you to recommend Essentials 4 Your Life to family or a friend:
    Not LikelyLikelyVery Likely
  11. Additional Comments:

    12. Your Name:

    Student's Name:

    Your email:

    What School did your daughter attend Essentials 4 Your Life Program?

    What state is that school in?

    Who was your daughter's teacher?

    Spam protection (enter the text captcha below):

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