Shreveport Opera Xpress Survey for SOX Performance Performance(Required) Leo, the Lyin' Lion Ralph the Rat Operatizers School(Required) Parish(Required) Date of Performance(Required) MM slash DD slash YYYY Contact Person(Required) PhoneAddress(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code DemographicsPlease give your best estimate for the following:Total Students in Attendance(Required)Total Teachers/Adults in Attendance(Required)Grade Levels(Required) Pre-K Kindergarten 1st 2nd 3rd 4th 5th 6th 7th 8th 9th 10th 11th 12th # with Special Needs(Required)% White(Required)% Black(Required)% Other(Required)% Military(Required)Post PerformanceHow would you rate the quality of the performance?(Required)PoorFairGoodExcellentWas it easy to understand the performers?(Required)Not at allMostly NoMostly YesVeryOn a scale of 1-10, with 1 being “not at all” and 10 being “very”, how valuable was this performance?(Required)1 - Not at all2345678910 - very valuableDid this program have…?(Required)YesNo...a social message valuable to your students?...a positive impact on your students?Should we continue this program?(Required) Yes No Would you request us again?(Required) Yes No Shreveport Opera Xpress creates new productions annually. What social messages or topic(s) would best serve the needs of your students?Any Additional CommentsStudent FeedbackWe love student feedback! Please send this form, as well as any student drawings, notes and/or thank you letters to: Shreveport Opera, 6969 Fern Loop, Suite 206, Shreveport, LA 71105; boxoffice@shreveoportopera.org
