Outreach activities have been an ongoing commitment of the American Chemical Society and other scientific organizations, yet formal assessment of outcomes has been infrequent. We have designed a simple, reliable, and robust format for assessing attitudinal and motivational characteristics of participants attending informal public events that promote interest in and understanding of chemistry. In its final form, this 6-item survey can be distributed on the front and back of an 8.5 × 5.5 card (for pre- and postassessment). The form is provided in the Supporting Information and is available via ChemRxiv preprint draft (DOI: 10.26434/chemrxiv-2022-2zp5p) for noncommercial community use. Challenges in design included construct selection and independence, adjusting language for the grade 3-12 populations, physical form and distribution, efficiency and reliability of completion, and item performance and symmetry. Along with a description of the design process, psychometric characteristics and results of field testing at outreach events are described.