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Full Name(*)
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Group Name(*)
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Please detail as relevant: Soccer Club or Group Name / Team Name / Age Group / Team Gender.

Phone Number(*)
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E-mail(*)
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Services Used
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First year with Impact (*)
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Please detail the first year you began to work with Impact.

COACH AND SERVICE RATINGS. Please provide a score (1 - Poor, 5 - Very Good) and comment with regard to your coach(es) allocated this year. For example: 1 - Our coach always arrived to sessions on time and with full attendance.
Coach Preparation(*)

Punctuality and Attendance(*)
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Behavior Management Skill(*)
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Coaching and Content Knowledge(*)
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Level of player learning(*)
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Communication with myself and our team manager(*)
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General Service(*)
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Please pass on comment regarding the support service provided by Impact in regard to the trainer provided. Specific areas such as billing, scheduling or how our team dealt with any problems would be ideal.

Future Plans
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Please briefly detail your plans for the year ahead so that our team can get in touch at a suitable time. Please detail which of the services as listed in question 3 that you may be interested in.

Referral Program
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Please detail any contacts you have that may be interested in using Impact Soccer next year. Where such a referral leads to a seasonal sign up or camp your team will be credited $100 towards their next billing statement.

Contact
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Please detail if you would like immediate follow up in regard to your feedback our with regard to any area of our service. Please detail whether our team should initially get in touch via phone or email.

Where did you first hear about Impact programs(*)
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Thanks again you providing your feedback and using the services of Impact.
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