Instructions: Please print out this page, complete the evaluation, and return completed form to: Fred Friendly Seminars 2950 Broadway, Suite 101 New York, NY 10027 or Fax it to: (212) 854-8868 Name Address City                                                                       State                  Zip Phone                                                 E-mail 1. I am a: StudentEducatorMedia ProfessionalElected Official/Government Employee Other (please specify) 2. Check all that apply: I viewed the programI used the Discussion Guide I logged on to the Web site 3. On a scale of 1 to 4, with 4 being the highest ranking, please respond to the following:   1 2 3 4 How important are the issues this program addresses? How much do you feel you learned from the program? How effectively did the discussion guide support your efforts to engage this topic? How useful were the materials on the Web site? 4. Describe briefly how you used the program and the discussion guide in your community: 5. Do you plan any follow-up activities in your community/school/professional organization? 6. Please send me information about future Fred Friendly Seminars:YesNo