TOWN SHOP SURVEY

Date *

Date today

Name *

I am better off as a result of my participation with the Town Shop. *

I have utilized at least (1) or more coping skills learned from the Town Shop. *

I feel supported by the Town Shop staff and volunteers. *

My sense of self confidence has improved since programming with the Town Shop. *(example: Feeling capable of and having the courage to use skills and act.)

My sense of creativity has improved since programming with the Town Shop. *(example: Feeling able to bring creative ideas to the table)

I am better at communicating because of the Town Shop. *(examples: Exercising speaking in public, performing in front of a group, introducing myself to someone new)

I am better at cooperating with others because of the Town Shop. *(examples: Working with other participants to come up with programming, volunteering with a group to accomplish a common goal, collaborating on events and/or activities)

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