Form 3-2349 Alaska Guide Service Evaluation

OMB Control No. 1018-0141
Expires: XX/XX/2015

U.S. Fish and Wildlife Service
National Wildlife Refuge System
ALASKA GUIDE SERVICE EVALUATION
As a recent visitor to a national wildlife refuge in Alaska and a client of a refuge
authorized guide service, we request that you complete this survey and return it to us
using the enclosed envelope. You may also return the form via email, facsimile, or in
person to the refuge. We will also accept your responses over the telephone. Your
responses will help ensure that refuge visitors in Alaska receive high quality services
and experiences. You will not be contacted for further information unless you check the
box at the end of this form indicating that it is all right to do so. Please attach additional
sheets, if necessary.
1. Your name: _________________________________________________________
2. Name of guide on contract (if applicable): __________________________________
3. Name(s) of guide(s) that assisted you in the field: ____________________________
______________________________________________________________________
4. Activity for which you engaged the guide service (i.e. big game hunting, sport fishing,
river or float trip, etc.):
______________________________________________________________________
5. Dates and location of guided activity (river drainage or other significant geographic
reference):
______________________________________________________________________
6. Were the guide services provided as advertised or represented? Yes ____ No____
(if no, please explain):
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
7. Did you have any concerns about your personal safety during your guided activities?
Yes ____ No ____ (if yes, please explain)
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________

FWS Form 3-2349
REV 02/12

OMB Control No. 1018-0141
Expires: XX/XX/2015

8. Do you feel your guide took appropriate actions to prevent impacts on the
environment (e.g., practicing Leave No Trace techniques)?
Yes ____ No ____ (if no, please explain)
______________________________________________________________________
9. Overall, were you satisfied with the guide services provided to you?
Yes ____ No____ (if no, please explain)
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
10. Please provide any additional comments you would like regarding this guide service
or your refuge experience:
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
Thank you for your input!
May we contact you for more information?

Yes ____ No ____

If yes, please indicate a preferred method for contact (i.e., telephone, mail, email
address, etc.).
______________________________________________________________________
In accordance with the Privacy Act (5 U.S.C. 552a) and the Paperwork Reduction Act (44 U.S.C. 3501),
please note the following information. This information collection is authorized by the National Wildlife
Refuge System Administration Act (16 U.S.C. 668dd-ee). Your response is voluntary. We will use this
information to help ensure quality visitor services on national wildlife refuges in Alaska. We will aggregate
the information and use it only for statistical purposes. We do not maintain personal identifying information.
OMB has assigned OMB Control No. 1018-0141, which expires XX/XX/2015. Your response is not required
unless a currently valid OMB control number is displayed. We estimate that it will take 15 minutes to
complete this form. You may direct comments regarding the burden estimate or any other aspect of the
form to the Service Information Collection Clearance Officer, Fish and Wildlife Service, Mail Stop 2042-PDM,
Arlington Square, U.S. Department of the Interior, 1849 C Street, NW., Washington D.C. 20240

FWS Form 3-2349
REV 02/12