Name:

Position:

School:

Phone:

City:

Email:

Number in viewing program:

Grade level:

Are you in a: (Rural area ) (Suburban area ) (Inner City )

1. With what subject or course was this the program used?

2. Did you receive the program:
(via satellite ) (cable ) (video tape )

3. Please rate the content of the televised program:
(excellent ) (4 ) (3 ) (2 ) (poor )

4. How did you use the curriculum materials with your students?

5. Please rate the effectiveness of the curriculum material:
(excellent ) (4 ) (3 ) (2 ) (poor )

6. My overall impression of the program was:

7. How do you utilize the Internet as a teaching tool?

8. How did you find out about Achievement TV?