TMA Hard Hats for Little Heads Event Survey

Event date:  

Did you give helmets at a: 

Other (please specify): 

If you partnered with another group, please select the type of co-sponsor (check all that apply)

Other (please specify):

How many helmets did you give away?

How many helmets went to children of low-income families (approximate percentage)?

How many hours were spent planning and executing your event? (include all volunteer time, but not paid staff time)

If a physician participated in your event, please indicate the type of involvement (check all that apply):

Other (please specify):

Please provide quotes from helmet recipients for TMA to share with program funders.  

What suggestions/comments do you have for the Hard Hats for Little Heads program?  

Name:   

Organization/Title:   

Phone number:   

By completing a survey, you give TMA and TMA Foundation permission to use your feedback.