Take a Video Home Weekend

Questionnaire

Please give us your feedback using this survey form. Your input will help us improve the “Take a Video Home” community-service project and bring the project to other schools. Please answer each question below before submitting the form. Thank you for your participation in this worthwhile project.

1. Please select the movie you watched.

The Buttercream Gang	Willy the Sparrow
Friendship's Field	No More Baths
Bellflower Bunnies	Return to the Secret Garden
The Seveth Brother	The Princess and the Pea

2. Movie Format.

DVD VHS

3. Watched Had already seen No time to watch

4. Returning Keeping

5. Would you enjoy seeing more movies like these?

Yes No

6. Would you like the school to repeat this program?

Yes No

7. Do you usually Rent or Purchase films?

8. What character values would you like to see stressed in future
films for this program?

	1.
	2.

Your Information: (All fields with an * are required.)

First Name*		Last Name*

Home Phone*		E-mail Address*

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Having difficulties? We're here to help. Please call 1-800-FAMILY-TV with questions.