Your Email Address(you will receive a copy of this form): Title (exactly as appears on application): Adult Juror's Name: Facilitator's Name (if different): Date (MM/DD/YY): (use numbers only please, no letters) Children's Age Range: # of boys: (numbers only please) # of girls: (numbers only please) Ethnic Make-up : Rate each question: Select from the popup menu the number that best matches each question 5 = Great; 4 = Good; 3 = Good, but...; 2 = OK; 1 = Not So Good; 0 = Terrible; N/A = Not Applicable APPEAL 1. Did you like this recording? Why? -Select One- 5 - Great 4 - Good 3 - Good, but... 2 - O K 1 - Not So Good 0 - Terrible N/A - Not Applicable 2. Would you enjoy listening to this CD again? Why? -Select One- 5 - Great 4 - Good 3 - Good, but... 2 - O K 1 - Not So Good 0 - Terrible N/A - Not Applicable CONTENT 3. Can you relate to the words or music? Explain. -Select One- 5 - Great 4 - Good 3 - Good, but... 2 - O K 1 - Not So Good 0 - Terrible N/A - Not Applicable 4. Did it make you think about people or things you know? Explain. -Select One- 5 - Great 4 - Good 3 - Good, but... 2 - O K 1 - Not So Good 0 - Terrible N/A - Not Applicable 5. How well does it represent diversity? Explain. -Select One- 5 - Great 4 - Good 3 - Good, but... 2 - O K 1 - Not So Good 0 - Terrible N/A - Not Applicable 6. Are human values affirmed? Describe. -Select One- 5 - Great 4 - Good 3 - Good, but... 2 - O K 1 - Not So Good 0 - Terrible N/A - Not Applicable 7. Is the CD respectful of persons your age? Explain. -Select One- 5 - Great 4 - Good 3 - Good, but... 2 - O K 1 - Not So Good 0 - Terrible N/A - Not Applicable PRODUCTION QUALITY 8. Rate the quality of the recording. Describe. -Select One- 5 - Great 4 - Good 3 - Good, but... 2 - O K 1 - Not So Good 0 - Terrible N/A - Not Applicable 9. Comment on originality, creativity, musical appeal? -Select One- 5 - Great 4 - Good 3 - Good, but... 2 - O K 1 - Not So Good 0 - Terrible N/A - Not Applicable BENEFITS 10. Did the CD inspire you to inquire about an idea, or about the artist? -Select One- 5 - Great 4 - Good 3 - Good, but... 2 - O K 1 - Not So Good 0 - Terrible N/A - Not Applicable 11. What was your favorite part? Please total the points for questions 1 through 10: This title was  :  Great!  I'd listen to it again  OK, I liked some of it  Boring  Too fast/too slow  Doesn't appeal to everyone  The stereotypes are negative  Nobody liked it FINAL RATING:   NO   QUALIFIED YES   YES   ALL-STAR  Contains gratuitous sex or violence  Has a condescending attitude towards children  Contains physical or verbal abuse  Contains racial, gender, cultural or religious bias  Models unsafe behavior Indicate if you've given it a QY for one of the following reasons or explain other reasons.  Pace inappropriate, too slow/fast  Stereotypical behavior prominent  Lacking in cultural diversity  Appealing to special audience This title meets or exceeds the baseline criteria: No gratuitous sex or violence No racial, gender, culture or religion bias No unsafe behavior No condescension towards children No verbal or physical abuse What are the specific attributes? (use all-star check list): Tell us why you gave the final rating above: When you are finished, please click the submit button below :