Interactions for Peace Online Submission Form

Interactions for Peace ^©Online

Program Feedback and Needs Assessment Survey

This form is both a survey and a method for you to provide Us feedback regarding Current Program Participation, Past Program Participation, Trainings, Workshops and Seminars.

We would also like to know your probable future involvement with Interactions for Peace ^© and Our Integrated Set of Conflict Resolution and School Safety Programs.

* = required field(s)

Your Name: *

Your Organization:

Your E-Mail Address: *

Is your School or Organization currently implementing the PRIMARY PEACEMAKERS Program?
Yes
No

Is your School or Organization currently implementing the PEACE PATROL Program?
Yes
No

Is your School or Organization currently implementing the MIDDLE SCHOOL MEDIATORS Program?
Yes
No

Is your School or Organization currently implementing the BULLIES BEWARE! Program?
Yes
No

Notes/Feedback pertaining to Current Program Participation:

Has your School or Organization implemented the PRIMARY PEACEMAKERS Program in the Past?
Yes
No

Has your School or Organization implemented the PEACE PATROL Program in the Past?
Yes
No

Has your School or Organization implemented the MIDDLE SCHOOL MEDIATORS Program in the Past?
Yes
No

Has your School or Organization implemented the BULLIES BEWARE! Program in the Past?
Yes
No

Notes/Feedback pertaining to Past Program Participation:

Have you, your School, or your Organization attended an PRIMARY PEACEMAKERS Workshop, Training Session or Seminar in the Past?
Yes
No

Have you, your School, or your Organization attended an PEACE PATROL Workshop, Training Session or Seminar in the Past?
Yes
No

Have you, your School, or your Organization attended a MIDDLE SCHOOL MEDIATORS Workshop, Training Session or Seminar in the Past?
Yes
No

Have you, your School, or your Organization attended a BULLIES BEWARE! Workshop, Training Session or Seminar in the Past?
Yes
No

Notes/Feedback pertaining to Past Workshops, Training Sessions or Seminars:

Would you, your School, or your Organization consider coordinating/attending a Beginning one-day Workshop, Training, or Seminar to implement the PRIMARY PEACEMAKERS program in the future?
Yes
No

Would you, your School, or your Organization consider coordinating/attending a Beginning two-day Workshop, Training, or Seminar to implement the PEACE PATROL program in the future?
Yes
No

Would you, your School, or your Organization consider coordinating/attending a Beginning two-day Workshop, Training, or Seminar to implement the MIDDLE SCHOOL MEDIATORS program in the future?
Yes
No

Would you, your School, or your Organization consider coordinating/attending a Beginning three-day Workshop, Training, or Seminar to implement the PRIMARY PEACEMAKERS and PEACE PATROL programs in the future?
Yes
No

Would you, your School, or your Organization consider coordinating/attending a Beginning three-day Workshop, Training, or Seminar to implement the PEACE PATROL or MIDDLE SCHOOL MEDIATORS program and the BULLIES BEWARE program in the future?
Yes
No

Would you, your School, or your Organization consider coordinating/attending an Advanced support one-day Workshop, Training, or Seminar for an existing implementation the PEACE PATROL program or another peaceful conflict resolution program in the future?
Yes
No

Please feel free to use the text area below to provide us with ways that we can improve our Organization and/or Our set of Programs:

I am interested in or would like more information regarding individual/focused training for my School or Organization.
Yes
No

Interactions for Peace ©

Educating and creating peaceful problem solvers