CLASS:_________________________________ INSTRUCTORS NAME:_________________________
DATE OF EVALUATION:_____/_____/_____
Please take a minute to complete the following short survey regarding your feedback about the class that you or your child
is taking. The YMCA will use this form to make adjustments and to be responsive to your needs as a member or program
participant. Circle one please, if you answer NO feel free to use the space provided to explain
why you answered NO.
1. Does the class start and end on time? Yes No ______________________
2. Is the instructor prepared for class? Yes No ______________________
3. Are you happy with the staff teaching the class? Yes No ______________________
4. Are you or your child meeting your goals? Yes No ______________________
5. Does the facility meet your expectations? Yes No ______________________
6. Is the YMCA staff friendly and courteous? Yes No ______________________
7. Is a safe environment maintained at all times? Yes No ______________________
8. Is the class focusing on character development
in addition to skill development? Yes No ______________________
9. What do you like most about the class you or your child is taking?
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
10. What one change would you like to see made to improve the program? ___________________________________________________
_____________________________________________________________________________________________________________
11. What other programs are you currently enrolled in or are interested in learning more about? _______________________________________________________________________________________
_______________________________________________________________________________________
Please drop off evaluations in the evaluation box in the lobby at the YMCA.
Thank you for your time, YMCA Management Staff.
CUMBERLAND YMCA
601 Kelly Road
Cumberland, MD 21502
301-777-9622