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 Poor Poor Average Above Average High
  2. After my daughter completed the Essentials 4 Your Life program, her self-confidence has:
     Declined Stayed the same Improved Greatly Improved
  3. My daughter’s personal care regimen has:
     Declined Stayed the same Improved
  4. My daughter’s overall health and nutrition has:
     Declined Stayed the same Improved
  5. My daughter’s overall etiquette has:
     Declined Stayed the same Improved
  6. My daughter’s relationships are:
     Declining No change Improving Much 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 improvement Very little Improving Major improvement
  8. Have you seen a decrease in any problem behaviors your daughter may have had prior to taking Essential 4 Life’s program?
     Yes No No problem behaviors
  9. Have you seen an overall improvement in your daughter?
     No improvement Very little Improving Major improvement
  10. How likely are you to recommend Essentials 4 Your Life to family or a friend:
     Not Likely Likely Very 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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