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Personal Training Form

Name-
Telephone-
Adress-
E-mail-
Age-              Weight-               Height-

Do you take any medications?

Do you smoke?

Are you pregnant?

How many time do you plan exercise a week ?

Do you have a specific trainer in mind?

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Sandra Aparecida da Silva Santos

Thank you for visiting our Farm Hotel. To improve our service, please answer the following questions.

1. Did the reception team help you when you arrived?

(   )   Yes         (   )  No

2. Was your room clean and organized?

(   )  Yes

(   ) No        What’s wrong? _______________________________

3. You used our restaurant?

(   )  Yes      (   ) No

4. What did you think of our meals?

(  ) Excellent     (  ) Good    (  ) Regular   (  ) Bad
5. Do you have any suggestions to improve the service in the restaurant?

(   ) Yes       What?_________________________

(   )  No

6. Did you make the tours available at the hotel?

(   ) Yes      (   ) No

7. Do you have a ride that would be unnecessary?

(   )  Yes       What? _____________________________________

(   ) No

8. Did you make use of the hotel pools?

(   ) Yes      (   ) No

9 - Would you like to leave a suggestion to improve our service quality?

(   )  Yes   _______________________________

(   ) No

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Hotel Uel
Name:
Age:

Thank you for staying at our hotel. We would like to know your opinion about our facilities:

Reason for the trip:
( ) Work
( ) Vacation

What did you travel with?
( ) Friends
( ) Family

What did you think of the cleaning?
( ) Bad

( ) Regular

( ) Good

( ) Great

What did you think of our facilities?
( ) Bad

( ) Regular

( ) Good

( ) Great

What did you think about the service provided by the employees?

( ) Bad

( ) Regular

( ) Good

( ) Great

Would you like to leave a comment about what you liked and what you didn't?

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Hugo Roldi Guariz
Your travel expectations are important to serve you better. Answer the questions below:
1) What is the best form of hosting?
( ) hotel
( ) hostel
( ) camping
( ) couchsurfing app
( ) airbnb app
( ) resorts

2) Where do you like to travel the most?
( ) big cities and metropolitan centers
( ) mountains
( ) beaches
( ) forests and and hike

3) Do you rent a car when you travel?
( ) yes
( ) no

4) Do you hire tour guide services?
( ) yes
( ) no

5) Do you practice any extreme sports?
( ) yes, What? _______________________
( ) no

6) How many times do you travel a year?
_______________________________________

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Do you like theater?
(  ) I hate
(  ) It’s indiferente for me.
(  ) I like it.
(  ) I love it!

How often do you go to the theater?
(  ) never.
(  ) sometimes.
(  ) always.

When was the last time that you went to the theater?
____________

Do you support the local artista?
____________

What’ do you like to see at the theater?
(  ) drama
(  ) tragedy
(  ) comic
(  ) epic

Did you visit some theater in Londrina?
___________

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Rodrigo Yudi Palhaci Marubayashi - Periodic inspection of sprayers 

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Rodrigo Yudi Palhaci Marubayashi - Periodic inspection of sprayers 

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Please answer the questions below.

A - Personal data
1 - Name
_________________________________
2 - E-mail
_________________________________
3 - Phone number
_________________________________
4 - Farm name
_________________________________
5 - Geographic coordinates
_________________________________

B - Qualitative Assessments
1 - Are there hoses damaged?
( )Yes, there are
( ) No, there aren't

2 - Are there hoses misplaced?
( )Yes, there are
( ) No, there aren't

3 - Are there anti drip?
( )Yes, there are
( ) No, there aren't

4 - What is the status of the anti drip?
( ) New
( ) Used but in good condition
( ) Terrible

5 - Is there protection from moving parts?
( ) Power take off
( ) Pulley
( ) Belt

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ALEXANDRE VOLTA - FORM FOR UEL AGRONOMY STUDENTS

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ALEXANDRE VOLTA - FORM FOR UEL AGRONOMY STUDENTS

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NAME : ______________________________
EMAIL: ______________________________

1-  How do you rank the teaching methodology?
() Excellent
() Great
() Good
() not good

2 - Were the teachers good?
() Yes
() No

3- Does the university structure meet all needs?
() Yes
() No
() Perhaps

4- In which year are you?
() First
() Second
() Third
() Fourth
() Fifth

5- Whats is your favorite subject?
________________________________________________________________________________________

6- Suggestions to improve the course:
__________________________________________________________________________________________

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Danilo Ciuffa Camargo - Customer Satisfaction

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Danilo Ciuffa Camargo - Customer Satisfaction

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1- Did you think the confortable room?
( ) Yes
( ) No

-How can we improve?
________________________

2- What do you think about our restaurant?
______________________________

3- Did you use the pool?
( ) Yes
( ) No

4- What do you think about our reception?
___________________________

5- Would you recomend our services to a friend?
( ) Yes
( ) No

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Thank you for visiting our department store. Please answer the questions below.

1 What type of product were you interested in?

(  ) clothes

(  ) acessories

(   ) shoes

2 What did your opinion about the quality our products?

(  ) very good

(  ) good

(   ) not good

3. How helpful were the sales team?

(  ) very helpful

(  ) helpful

(  ) it´s necessary improve

4.  Did you feel comfortable in the dressing rooms? What could improve?

( ) Yes

( ) No

5. Did you like our payment methods? Would you like other forms of payment?

( ) Yes

( ) No

6. Dou you purpose to visit us again?

( ) Yes

( ) No

7.  Would you recommend our store to a friend?

( ) Yes

( ) No

8.What comment would you make to improve our service?

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Maria Eduarda Crespi - customer satisfaction

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Maria Eduarda Crespi - customer satisfaction

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First name: _________
Last name: _________
E-mail: _____________

What did you think of the service?
________________________

The food was tasty?
( ) yes
( ) no

Was the service delayed?
( ) yes
( ) no

Do you recommend the restaurant to a friend?
( ) yes
( ) no

Do you have any suggestions? Write here:
__________________________

more information:
__________________________

Thank you!!

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Guest’s dietary restrictions form:

Arrival date:        ___/___/___
Departure Date: ___/___/___

First name: ______________
Last name: ______________
Gender: ______________
DOB: ___/___/___
Country of origin:____________

Condition special dietary:
(  ) Lactose intolerance.
(  ) Gluten intolerance or sensitivity.
(  ) Vegetarianism.
(  ) Veganism.
(  ) Kosher.
(  ) Keto diet.
(  ) Diabetes.
(  ) Dairy-free.
(  ) Low carb.

Food allergies:
(  ) Wheat.
(  ) Nuts.
(  ) Fish and shellfish.
(  ) Eggs.
(  ) Soy.

More information about you dietary restriction: ______________________________
_____________________________

Sabi Sands Lodges Reservations

Kruger National Park

South Africa

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Name: ______________________________
Age: ________________________________
Email: _______________________________

Level of Education:
(   ) primary education
(   ) secondary education
(   ) High School
(   ) College curse
(   ) Postgraduate

1 How often do you use a fossil fuel car in the week?
(   ) every day
(   ) twice a week
(   ) three or more times a week
(   ) Never

2 Do you usually turn on the air conditioning in the summer?
(   ) Yes, I don´t live without my air conditioning
(   ) Sometimes, when it´s too hot and my fan doesn´t supply my confort
(   ) Never, I don´t have air conditioning

3 How often do you wash your sidewalk with potable water?
(   ) At least once a week
(   ) Rarely
(   ) Never

4 How often do you buy organic food?
(   ) never
(   ) rarely
(   ) sometimes
(   ) usually
(   ) always

If you answered the first option in the 4 questions you need to rethink your sustainable habits.

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Full name: __________________
DOB:_____/______/_______
Phone: (___)___________________
Address: _____________________
Zip code: _____________________
City: __________________________
E-mail:________________________
Current occupation: __________

Do you have health insurance? What?
_______________________________

Do you have any chronic health conditions? (If yes, give details)
_______________________________

Do you have any allergies? (If yes, which ones?)
________________________________

Do you take any medicine? (If yes, which ones?)
________________________________

Have you been sick lately?
________________________________

Do you do physical activity?
________________________________

more informations
________________________________

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Name: ___________________________________
Birth date: _______________________________
Address: _________________________________
Phone: ___________________________________

Do you have any health problem?
______________________________________________________________________________________
Do you have any allergies? If so, specify:
______________________________________________________________________________________
Do you take continuous medications?
______________________________________________________________________________________
Do you have health ensurance?
______________________________________________________________________________________
In an emergency, who can we contact?
______________________________________________________________________________________

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 Maria Fernanda                                                  reading habit form

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 Maria Fernanda                                                  reading habit form

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Name : ________________________

email:__________________

How often do you read a book?
(  ) every day
(  ) twice a week
(   )every week
(   ) once a month

What kind book you like ?
(  )thriller
(   )novels
(   ) fantasy
Other:___________

What you favorite book ?
_____________

Are you reading any book at the moment ?
_____________

Share a book you like:
_______________

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Registration Form
WPDE   2021

First name ________________________________

Last name ________________________________

E-mail ________________________________

Institution _________________________________

Country          _________________________________

Category
(      )   Speaker*
(      )   Poster*
(      )  Participant

*Tittle of the Presentation

________________________________

* Abstract (maximum of 5 lines)
________________________________
________________________________
________________________________
_______________________________
_______________________________