Field Trip Survey

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* 1. Today's Date:

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* 2. Are you a:

Parent/chaperone

Principal

Teacher

Athletic director

Other (please specify)

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* 3. Field Trip WNA notification number (leave blank if you don't know the number):

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* 4. How was the trip reserved?

WNA

Email

On the phone

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* 5. Date of Field Trip:

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* 6. This trip was ordered:

More than 10 days prior to the trip date

Less than 10 days prior to the trip date

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* 7. Pick-up time (indicate time and a.m. or p.m.):

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* 8. Drop-off time (indicate time and a.m. or p.m.):

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* 9. Starting trip location and Destination:

	Start Location	Destination
A	A Start Location menu	A Destination menu
B	B Start Location menu	B Destination menu

Other (indicate start location and destination)

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* 10. Tell us about the experience with our service.

	Very Satisfied	Somewhat Satisfied	Neutral	Somewhat Dissatisified	Very Dissatisfied	Not Applicable
Service provided by the Field Trip Coordinator	Service provided by the Field Trip Coordinator Very Satisfied	Service provided by the Field Trip Coordinator Somewhat Satisfied	Service provided by the Field Trip Coordinator Neutral	Service provided by the Field Trip Coordinator Somewhat Dissatisified	Service provided by the Field Trip Coordinator Very Dissatisfied	Service provided by the Field Trip Coordinator Not Applicable
Service provided by the Bus Operator	Service provided by the Bus Operator Very Satisfied	Service provided by the Bus Operator Somewhat Satisfied	Service provided by the Bus Operator Neutral	Service provided by the Bus Operator Somewhat Dissatisified	Service provided by the Bus Operator Very Dissatisfied	Service provided by the Bus Operator Not Applicable
The trip was on schedule and driven safely	The trip was on schedule and driven safely Very Satisfied	The trip was on schedule and driven safely Somewhat Satisfied	The trip was on schedule and driven safely Neutral	The trip was on schedule and driven safely Somewhat Dissatisified	The trip was on schedule and driven safely Very Dissatisfied	The trip was on schedule and driven safely Not Applicable
The condition and cleanliness of the bus	The condition and cleanliness of the bus Very Satisfied	The condition and cleanliness of the bus Somewhat Satisfied	The condition and cleanliness of the bus Neutral	The condition and cleanliness of the bus Somewhat Dissatisified	The condition and cleanliness of the bus Very Dissatisfied	The condition and cleanliness of the bus Not Applicable
The overall experience of the bus service	The overall experience of the bus service Very Satisfied	The overall experience of the bus service Somewhat Satisfied	The overall experience of the bus service Neutral	The overall experience of the bus service Somewhat Dissatisified	The overall experience of the bus service Very Dissatisfied	The overall experience of the bus service Not Applicable

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* 11. The Bus Operator:

	Yes	No
Obeyed all safety/motor vehicle laws	Obeyed all safety/motor vehicle laws Yes	Obeyed all safety/motor vehicle laws No
Provided Bus Emergency Procedures	Provided Bus Emergency Procedures Yes	Provided Bus Emergency Procedures No
Arrived on time, within 5-10 minutes	Arrived on time, within 5-10 minutes Yes	Arrived on time, within 5-10 minutes No
Was knowledgeable of the route needed	Was knowledgeable of the route needed Yes	Was knowledgeable of the route needed No

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* 12. Comments