Name  

Title    

Grade level K 1 2 3 4 5 6 Other    Subjects taught

Average # of students taught per school year  

Average # of students per class  

School information

Name       

Address  

City           

State       AK AL AR AZ CA CO CT DC DE FL GA GU HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR RI SC SD TN TX UT VA VT WA WI WV WY Province AB BC MB NB NF NS NT ON PE QC SK YT

Zip or postal code  

Phone Number   Fax Number  

E-mail address  

1) Please evaulate the lesson plan based on the following criteria:

    Activities
     Very good    Satisfactory    Fair    Poor

    Diagrams/photos
     Very good    Satisfactory    Fair    Poor

    Ease-of-use
     Very good    Satisfactory    Fair    Poor

    Educational value
     Very good    Satisfactory    Fair    Poor

    Organization
     Very good    Satisfactory    Fair    Poor

    Readability
     Very good    Satisfactory    Fair    Poor

    Thoroughness
     Very good    Satisfactory    Fair    Poor

2) For what grade level do you feel our Battery Lesson Plan is best suited?

3) What modifications to the lesson plan would you suggest in order to make the material more applicable to other age groups?

4) How can we improve the Battery Lesson Plan?

5) Have you heard of RBRC before?

     Yes    No

    If so, how?

6) Have you attended or do you plan on attending any teacher conferences?

    If so, where and when?
     Yes    No

7) Do you read any teaching related publications?

     Yes    No

     If so, which ones?

8) If you haven't done so already, do you intend to use this curriculum?

   Yes    No

     If not, why?

Any other comments or suggestions?