Junior Active Leader Feedback Survey for Schools

Name of School / Course Host *

2. Please provide your overall rating of the following, using the scale 1=low to 5=high

3. Have you observed the following in the Junior Active Leaders?

a. Improved levels of confidence *YesNo

b. Improved collaboration peer to peer *YesNo

c. Improved concentration and behaviour *YesNo

d. Improved desire to be active *YesNo

4. Please provide any other observations you would like to make about the impact of the course on your pupils

5. Please provide a short description of how the Junior Active Leaders will continue their activity leadership in your school: *

6. Would you recommend the Junior Active Leader course to others *YesNo

7. Is there anything we could improve / change? *YesNo

Please provide detail of what could be improved / changed

8. Are you interested in booking another course *YesNo

Please indicate approximate dates for another course *

9. Would you or a member of your staff like to become an Accredited Trainer?YesNo

Please enter the name and contact e-mail of the person interested in training *

10. Approximately how many children do you think one Junior Active Leader helps to enjoy fun activity and games?

Please provide an overall comment which you would be happy for us to use

WhiteEnglish, Welsh, Scottish, Northern Irish or British Irish, Irish, Gypsy or Irish Traveller, Any other White background

Mixed or Multiple Ethic groupsWhite and Black Carribean, White and Black African, White and Asian, Any other Mixed or Multiple ethnic background

Asian or Asian BritishIndian, Pakistani, Bangladeshi, Chinese, Any other Asian background

Black, African, Carribean or Black BritishAfrican, Carribean, Any other Black, African or Carribean background

Other ethnic groupArab, Any other ethnic group

Prefer not to say

Unknown

Form completed by:

Name of teacher *

Position *

Email contact *