Student Evaluation Form

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

  1. Before attending Essentials 4 Your Life’s program, my self-confidence was:
     Extremely Poor Poor Average Above Average High
  2. After I completed the Essentials 4 Your Life program, my self-confidence is:
     Declined Stayed the same Improved Greatly Improved
  3. My personal care regimen has:
     Declined Stayed the same Improved
  4. My overall health and nutrition has:
     Declined Stayed the same Improved
  5. My overall etiquette has:
     Declined Stayed the same Improved
  6. My relationships are:
     Declining No change Improving Much healthier
  7. Have you seen any improvements in your 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 you may have had prior to taking Essentials 4 Your Life’s program?
     Yes No No problem behaviors
  9. Have you seen an overall improvement in yourself?
     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:

    Parent's Name:

    Your email:

    What School did you attend Essentials 4 Your Life Program?

    What state is your school in?

    Who was your teacher?

    Spam protection (enter the text captcha below):

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