DOM INNARELLA | ABOUT ME | FEEDBACK FORM

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DOM INNARELLA | ABOUT ME | FEEDBACK FORM

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SCHOOL *

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NAME OF STUDENT ORGANIZATION *

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ADVISOR *

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ADVISOR email *

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Please RATE ABOUT ME from 1-5 with 5 being the highest. *

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NEWSPAPERS: are you reviewing Dom-About Me? *

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If YES, on what issue date?

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NEWSPAPERS: article URL if published

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IF you rec'd them, how were the maerials distributec/handed out? *

given to students

posters hung AND given to students

posters hung in school

TV: did you broadcast-use the video?

yes

no

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TV: pls include URL if relevant

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comments-remarks

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