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Please complete the form below. Please answer all of the question to the best of your knowledge. Thanks for your support of the Pennsbury Partners Program!

PLEASE NOTE: All fields are required (except Comments box). You will not be able to submit the PAK activity without completing all the information. You can return to your PAK form within 5 business days to complete and submit your partnership activity.
Your E-Mail Address: *REQUIRED
  Company Name:
 
  Contact First Name:
  Contact Last Name:
  Job Title:
  Address:
  City:
  State:
  Zip:
  Phone:
  E Mail:
  Web Site:
  Subject
 

Teacher
 
 

Description of Partnership/Activity
(300 Chars max)

 

Choose A School:
 

Grade Level(s) Involved
Tip: Hold CTRL to select more than one.
 

Activity Date:
 

Number of Students:
 

Please check one:

 Business
Non-Profit
Government
Educational
 

Partner is a Parent

 Yes
No
Not Sure
  New Partnership/Activity
  Repeat Partnership/Activity
  Evaluation of Partnership Activity
 

Please select the appropriate ratings from 1 to 5
(1=poor  3=average 5=outstanding):
 

1.The program was meaningful and aligned with our curriculum goals.
 
1      2      3      4      5      Does Not Apply     
 
  2. The program was well planned and well coordinated.
 
1      2      3      4      5      Does Not Apply     
 
  3.   The program offered something special that could not be provided through other means without this business partnership.
 
1      2      3      4      5      Does Not Apply     
 
  4.   The presentation/program was well thought out and well delivered.
 
1      2      3      4      5      Does Not Apply     
 
  5.   The overall rating for this program/partnership effort is:
 
1      2      3      4      5      Does Not Apply     
  Comments (optional)
 
  I would like to see this partnership/event continue next year.
  Yes No
  I would recommend this partnership to another teacher/school.
  Yes No
 
  I'm Finished, submit this form for approval.
  I'm NOT Finished, I'll be back later to complete this form.