Beyond Differences Middle School Assembly Evaluation Form 2013-2014
(All answers will be kept confidential)
1.
With 5 being the most favorable number you can give, and 1 being the least favorable number, what
number would you give to the Beyond Differences assembly that came to your school? Please check
the number that describes your feeling about the assembly.
5______ 4_____ 3______ 2______ 1______
2.
Which part of the assembly did you like best and why? (Please write 2 sentences)
3.
Was there anything about the assembly that you did NOT enjoy or understand and why? (If yes,
please write 2 sentences)
4.
If you participated in a small-group discussion, who was your group leader? How engaging was the
discussion, on a scale from 1-5 (5 being most engaging, 1 being least)?
*Name of Group Leader______________ *Discussion Rating ____________ (1 – 5)
5.
Did you feel comfortable opening up in front of your classmates during small group discussions?
(Yes or No and please write 2 sentences)
6.
Did you feel comfortable opening up in front of your classmates as part of a large audience
discussion? (Yes or No and please write 2 sentences)
7.
Now that you’ve experienced a Beyond Differences assembly and understand what social isolation
is all about, will you commit to one or more of the following actions:
____Approach someone at school you usually don’t hang out with and reach out?
____Wear a Beyond Differences wristband and become part of the movement?
____Post something on your Facebook wall (if you have permission to have a Facebook
page!) sharing what you learned about social isolation?
____ Invite a few new friends to your home after school or on a weekend day?
8.
Would you like to become more involved with Beyond Differences?
Email address______________________ (optional)
Thank you!!!
336 Bon Air Center, #436 Greenbrae, CA 94904 Tel 415-256-9095 Email beyonddifferences@gmail.com
BeyondDifferences.org