School Name*

Address*

City*

Zip*

Name and Title*

Phone*

Date of Mission Field Trip*12345678910111213141516171819202122232425262728293031 JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember 199920002001200220032004200520062007200820092010201120122013201420152016201720182019

Mission Visited*

Number of 4^th Grade Classes*

Number of 4^th Grade Students attended*

Number of Teachers attended*

Number of Chaperones attended*

The trip to the mission was a valuable experience for the students.* Select ResponseStrongly AgreeAgreeNeither Agree nor DisagreeDisagreeStrongly Disagree

The school was able to meet the 20% match without difficulty.* Select ResponseStrongly AgreeAgreeNeither Agree nor DisagreeDisagreeStrongly Disagree

Students responded positively and put more effort into their mission projects.* Select ResponseStrongly AgreeAgreeNeither Agree nor DisagreeDisagreeStrongly Disagree

As a teacher, my knowledge increased and I was able to inspire my students.* Select ResponseStrongly AgreeAgreeNeither Agree nor DisagreeDisagreeStrongly Disagree

California Missions by Msgr. Francis Weber* Select ResponseVery HelpfulSomewhat helpfulNot at all helpful

The California Missions Activity Book by Arlan Dean and Kay Ward* Select ResponseVery HelpfulSomewhat helpfulNot at all helpful

New Perspectives on the California Missions by Delores Hendricks, et al.* Select ResponseVery HelpfulSomewhat helpfulNot at all helpful

The California Missions Sourcebook by David Laughlin* Select ResponseVery HelpfulSomewhat helpfulNot at all helpful

Sourcebook laminated pages* Select ResponseVery HelpfulSomewhat helpfulNot at all helpful