Film Evaluation: Bowling Green, OH - Diversity & Inclusi

Not In Our Town/DOJ COPS Office Film Evaluation

Bowling Green, OH- Diversity and Inclusion

Please answer the following questions based on your recent viewing of XX. Thank you for your participation.

1) Screening Location: ____________________________________________________

2) How would you rate the following in reference to this film?

	5 Excellent	4 Good	3 OK	2 Fair	1 Poor
a. Handling of topic presented
b. Overall impact of film
c. Effectiveness of group discussion (if applicable)

3) Has this screening provided you with the following?

	Yes, very much	Yes, somewhat	No, didn’t make a difference	Not applicable
a. Information or tools you can use in your work
b. Increased motivation to prevent hate, intolerance, and/or bullying in your community
c. New ideas on how hate crimes and hate incidents should be reported and tracked
d. New ideas engaging students and communities to prevent hate, intolerance and/or bullying
e. Increased commitment to work with students and communities to address hate, intolerance and/or bullying

4) What opportunities and/or challenges do you anticipate in using this film within your community or agency?

5) What additional information or supplemental resources would you like to see presented in films and discussions to support your training and outreach efforts?

6) Additional comments?

7) Demographic Information

We request the following information to help us understand and better serve our audience. Thank you.

a. Gender ☐Male ☐Female ☐ Other

b. Age ☐12 or younger ☐13-18 ☐19-25 ☐26-35 ☐36-45 ☐46-55

☐56-65 ☐66+

c. Ethnicity ☐Hispanic or Latino

☐ Not Hispanic or Latino

d. Race ☐American Indian or Alaska Native ☐Asian ☐Black or African American ☐Native Hawaiian or Other Pacific Islander ☐White

e. Constituency ☐Law enforcement ☐Student ☐Educator ☐Community member

☐Civic leader ☐Faith group member ☐Other__________________

f. Occupation

Would you like to receive more resources or updates from Not In Our Town?

If yes, please provide: Name ________________________________________________

Phone ________________ Email ___________________________

Thank you for your participation!

For more information on how to prevent hate, intolerance, and bullying in your community, please visit the Not In Our Town website at www.niot.org.

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