T-Rex: Her Fight for Gold Evaluation Toolkit
Thank you for partnering with ITVS to present Indie Lens Pop-Up screenings of T-Rex: Her Fight for Gold in
your community! The enclosed evaluation tools will help us measure our success in raising awareness,
increasing knowledge, and inspiring action amongst event participants nationwide. Please help us capture
feedback from participants at your events by distributing copies of this survey at your event(s) and in a followup email to your event mailing list.
We will prepare a summary report of national findings from these surveys for our funders and the filmmakers.
We will share a summary of these results with you, including the results for your city.
Included in the toolkit are:
●
A paper survey for you to photocopy for distribution to all participants at your event(s). Surveys must
be copied/printed double-sided in order to connect the pre- and post-responses to the same
individual.
Please note the first page (Part 1) is to be completed BEFORE the film screening, and the second page
(Part 2) is to be completed AFTER the film screening.
Tips to increase the number of surveys collected at your event(s):
1. Place a survey on every seat in your screening room, or post a staff member or volunteer at the
entrance to hand surveys to participants entering the theater
2. Have your moderator make an announcement at the beginning of the event and at the conclusion of the
event, encouraging participants to complete the survey
3. Announce the $100 Amazon Gift Card giveaway as an incentive to complete the survey
4. Post a staff member or volunteer at the exit at the conclusion of the event to collect surveys and remind
participants to complete the survey
5. Place a box or basket, clearly labeled “Completed Surveys” on your information or registration table
Please send all completed paper surveys to:
T-Rex: Her Fight for Gold Audience Survey
c/o ITVS, Engagement
651 Brannan Street, Suite 410
San Francisco, CA 94107
T-REX: HER FIGHT FOR GOLD
AUDIENCE SURVEY
Complete both sides of this survey for a chance
to win a $100 Amazon gift card! Provide your email
address on page 2 to enter the prize drawing.
Winners will be announced September 2016.
PART 1 (Before the Film)
****COMPLETE ONLY THIS SIDE BEFORE THE FILM BEGINS****
Your feedback will help us shape future events. Your responses will remain confidential. Thank you for your time!
1. Location of Screening Event (City/State): ___________________________________
2. What is your home zip code? __________________________
3. Are you a member of your local PBS station?
4. What is your current age group?
5. What is your gender?
[ ] Female
[ ] Under 18
[ ] Male
[ ] yes
[ ] no
[ ] 18 – 34
[ ] not sure
[ ] 35 – 49
[ ] 50 – 69
[ ] Over 70
[ ] Other: _____________________
6. How would you describe yourself?
[ ] Latino/Latina [ ] African American [ ] Asian American/Pacific Islander [ ] Middle Eastern
[ ] Native American/Native Alaskan [ ] Caucasian [ ] Multiracial [ ] Other: _____________________
7. What is the highest level of formal education you have completed?
[ ] Elementary School [ ] Middle/High School [ ] College/University [ ] Graduate School
[ ] Vocational/Technical School [ ] Not Applicable [ ] Other: _____________________
8. Which of the following best describes your main means of watching films and video? Select no more than two:
[ ] Watch live broadcast television
[ ] Watch on an “over-the-top” device (Apple TV, Roku, Google TV, etc.)
[ ] Watch recorded television (e.g. DVR or TiVo) [ ] Watch online, on a computer (Netflix, Hulu, Amazon, etc.)
[ ] Other: ________________________________
9. Have you ever attended an Indie Lens Pop-Up event before?
[ ] Yes [ ] No [ ] I'm not sure
10. Had you heard of the PBS series Independent Lens prior to attending today’s event?
[ ] Yes [ ] No [ ] I'm not sure
11. How would you rate your current level of awareness about women and girls representation in sports?
(1 = not at all aware; 5 = very aware)
1
2
3
4
5
12. At this moment, on a scale of 1-5 (1 = not at all likely; 5 = very likely) how likely are you to…
Take time to learn more about athletic and mentorship programs for young people 1
2
3
Do something to get involved locally to support participation of
1
2
3
young people in athletic and mentoring programs
Donate to or become a member of your local PBS station
1
2
3
4
4
5
5
4
5
1
T-REX: HER FIGHT FOR GOLD
AUDIENCE SURVEY
Complete both sides of this survey for a chance
to win a $100 Amazon gift card! Provide your email
address on page 2 to enter the prize drawing.
Winners will be announced September 2016.
PART 2 (After the Film)
****COMPLETE THIS SIDE AFTER THE FILM ENDS****
1. Your email address (optional): _________________________________________________________
2. How would you rate your current level of awareness about women and girls representation in sports?
(1 = not at all aware; 5 = very aware)
1
2
3
4
5
Please explain:
4. At this moment, how likely are you to…
(1 = not at all likely; 5 = very likely)
Take time to learn more about athletic and mentorship programs
for young people
1
2
3
4
5
Talk to friends or family about the importance of providing access
to athletic and mentorship programs for young people
1
2
3
4
5
Do something to get involved locally to support participation of
young people in athletic and mentorship programs
1
2
3
4
5
Donate to or become a member of your local PBS station
1
2
3
4
5
Watch T-Rex when it airs on Independent Lens on PBS
1
2
3
4
5
Attend future Indie Lens Pop-Up screenings
1
2
3
4
5
5. If you are likely or very likely to get involved locally to support participation of women and girls in sports,
please tell us what action you are considering taking:
6. Please feel free to share additional comments about T-Rex and today’s event:
7. Would you like to receive the Independent Lens e-newsletter to receive updates on upcoming films?
[ ] yes
[ ] no
2