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National Film and Sound Archive of Australia
Black Screen Feedback Form
Contact Details
Name
*
Community
*
Street Address
*
State
*
Postcode
*
Event Details
Date of Event
*
Day
1
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Day
Month
Jan
Feb
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Apr
May
Jun
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Aug
Sep
Oct
Nov
Dec
Month
Year
2016
2017
2018
2019
2020
2021
2022
Year
How did you advertise the event?
*
Word of mouth
Flyer
School screenings
Internet/Website
Newspaper
Radio
TV advertising
What titles were screened?
*
Please indicate how suitable the material was for your audience
*
- Select -
Not at all suitable
Not very suitable
Not sure
Quite suitable
Very suitable
How many screenings did you run?
*
How many people attended each screenings?
*
Overall how would you rate your experience of Black Screen?
*
- Select -
Poor
Ok
Good
Very Good
Excellent
Ages of people who attended the screenings:
*
Under 18
18–24
25–34
35-50
51-65
Over 65
Is this the first time Indigenous films have been screened in your area?
*
Yes
No
How many other Indigenous screenings have there been?
Where did you hear about the Black Screen program?
*
Would you borrow from Black Screen again?
*
Yes
No
Do you have any suggestions that would help us to improve Black Screen?
I accept that the feedback I provide may be used for promotional purposes:
*
Yes
No
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