Parent Satisfaction Survey

***Please fill out a survey for each family member that you have participating in karate***

Hello: You are invited to participate in our survey to discuss the progress here at Brian Mayes Karate. It will take approximately 2 minutes to complete the questionnaire.

Your participation in this study is completely voluntary. If you have questions at any time about the survey or karate classes, you may contact us at (540)432-8400 or by email at [email protected].

Thank you very much for your time and support. Please start with the survey now by clicking on the Continue button below.

For each attribute listed below, please indicate the extent of improvement you've seen since starting training at Brian Mayes Karate

	Substantial Improvement	Clear Improvement	Small Improvement	No Improvement	Not Applicable- This attribute was sufficient before starting karate
* Ability to Stay Focused

* Confidence

* Coordination

* Eating Habits

* Getting Along with Others

* Grades in School

* Respect for Others

* Respect for Themselves

* Self-Discipline

Optional- In what other areas have you seen improvement?

Optional- Please add any other comments or input you'd like us to know:

Optional Contact information (Please include this if you would like to set up a progress check with your instructor):

Member's First Name :
Member's Last Name :

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