Service Branch
US Navy   US Marine Corps   Other

Battle Group / ARG / MEU / Other

Location
(i.e. ship, command, unit, etc.)

Warfare Area
(i.e. surface, aviation, amphibious, etc.)

Name

Email Address

Paygrade
Select E1 E2 E3 E4 E5 E6 E7 E8 E9 W1 W2 W3 W4 O1 O2 O3 O4 O5 O6 O7 O8

How did you hear about the UNITED THROUGH READING® program?

P.O.D.
Pre-Deployment Activity  
Word of Mouth
Spouse
Other 

Please provide the following information

Age(s) of Child(ren)
(list all, separated by commas)

Number of  videotapes made?

How many recording sessions did you do?

Approximate number of books you read aloud on each tape.

Number of personal books mailed home with video

What did you like MOST about the program?
(Please Describe)

What did you like LEAST about the program?
(Please Describe)

In your opinion, how valuable was this program as a quality of life enhancement for you and your family?
(1 is low and 5 is high) 
1     2     3     4     5

How has your experience of reading aloud on video tape affected the following:

Your child's ability to understand your absence
(1 is low and 5 is high)
1     2     3     4     5 

Your sense of personal connection to child(ren)
(1 is low and 5 is high)
1     2     3     4     5

Your sense of involvement in the parenting process
(1 is low and 5 is high)
1     2     3     4     5

What type of response did you receive from the child you read to?
(Please describe: email, videotaped reaction, picture, note, etc.) 

Would you participate in this program on your next deployment?
Yes     No 

Would you like to be a volunteer with this program during your next deployment?
Yes     No 

Is there any other information that you think would be helpful to report to United Through Reading?

May we email your spouse a participant survey? If so, please enter e-mail address