U.S. - Russia Experts Forum
American Delegates
Department of State administered
Pre-Program Survey
Please know that your answers will be strictly confidential and will in no way affect your participation in the program. We will use the data for analytical and evaluative purposes only.
Please feel free to give us your honest opinions. This survey is not a test, and there are no right or wrong answers. Thank you for your participation in this survey.
Privacy Act and Paperwork Reduction Act Statements:
The information solicited on this survey is requested pursuant to the Government Performance and Results Act of 1993 (P.L. 103-62) and the Mutual Educational and Cultural Exchange Act of 1961, as amended, also known as the Fulbright-Hays Act (22 U.S.C. 2451, et seq.). In order to ensure that the U.S. Department of State’s international exchange programs meet statutory program requirements (22 U.S.C. 2460(c)), the Department’s Bureau of Educational and Cultural Affairs (ECA) regularly monitors the programs, gathers data about program accomplishments, and evaluates selected ones. ECA uses the information collected to inform program design, management, and funding. All personal information that is collected through surveys is considered confidential. All responses are coded to ensure the confidentiality of individual responses. Data collected under this study will not be shared, sold, or used for fundraising purposes. Survey data and findings will be used only in an aggregate form for the express purposes of fulfilling the data needs of the outcome assessment. Responses to this survey are voluntary.
Public reporting burden for this collection of information is estimated to average ten (10) minutes to respond to this survey, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An Agency may not conduct or sponsor, and respondents are not required to respond to, a collection of information unless it displays a valid OMB control number. Please send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to: A/ISS/DIR, U.S. Department of State, Washington, D.C. 20520.
Which
research group are you participating in? Please
choose one.
Primary focus |
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Anti-corruption |
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Education for Innovative Societies |
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Energy Security |
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Immigration Issues |
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Infectious Diseases |
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International Security (Nonproliferation, Counter-terrorism) |
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NGO and Third Sector Development |
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Trade |
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World Economy |
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There are many different reasons people want to participate in this program. In the table below, please choose the three most important to you.
Reason |
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To collaborate on policy briefs at U.S. think tanks, governmental agencies, and research centers. |
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To foster dialogue and partnerships between U.S. and Russian experts on public policy issues and processes. |
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To learn more about my field of policy expertise |
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To develop my professional contacts and network |
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To further develop and advance my professional skills |
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To gain greater depth and breadth of knowledge about my policy field |
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To experience being part of a larger policy community |
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To affect, to the extent possible, my country’s policy on a particular local issue |
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To affect, to the extent possible, my country’s policy on a particular regional issue |
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To affect, to the extent possible, my country’s policy on a particular national issue |
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To affect, to the extent possible, my country’s policy on a particular international issue |
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Other: (please write in)
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Please rate your abilities in the following areas. Please check one box in each row.
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No knowledge |
Less than basic |
Basic knowledge |
Beyond basic |
Advanced knowledge |
Collaborative policy research |
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Statistical and analytical skills |
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Networking |
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Facilitation of policy discussions in my field |
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Policy recommendation formulation |
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Leadership |
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Communication of various policy recommendations and options |
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What are your expectations of the collaborative work process?
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Have you done this type of work process before?
Yes____ No____
Please rate your understanding or knowledge of the following topics. Please check one box in each row.
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No knowledge |
Less than basic |
Basic knowledge |
Beyond basic |
Advanced knowledge |
Russian democracy |
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Russian economy |
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Russian values and culture |
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Religious and ethnic diversity in Russia |
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Freedom of speech and the press in Russia |
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Voluntary community service |
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Daily life in Russia |
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How do you view the Russian government and the Russian people?
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Strongly unfavorable |
Generally unfavorable |
Neither favorable nor unfavorable |
Generally favorable |
Strongly favorable |
Russian government |
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Russian people |
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How do you view the Russian government and its relationship with the U.S.?
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Strongly Disagree |
Disagree |
Neither Agree nor Disagree |
Agree |
Strongly Agree |
The Russian government is a trustworthy partner for my country. |
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9. Please describe the organization or company that you work for. Please check one.
University |
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Research institution |
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Government |
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Non-profit organization |
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Private organization |
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Other: (please write in)
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10. What is your job title? ________________
11. Home city/town: _________________
12. Geographic location:
I live in… |
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My state’s capital city |
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Another major city other than the capital |
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A small city, town or rural location |
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13. Date of birth (day/month/year) Ex: 20/10/1978:
14. Sex:
Female |
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Male |
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15. What religious group do you consider yourself a member of or feel closest to? Please choose one.
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Baha’ism |
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Shintoism |
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Buddhism |
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Sikhism |
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Christianity |
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Taoism |
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Confucianism |
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Zoroastrianism |
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Hinduism |
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Not close to any group |
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Islam |
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None |
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Jainism |
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Other: please write in. |
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Judaism |
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16. Which language do you consider to be your native language/mother tongue? ______________
17. Thank you for completing this survey! If you have any additional comments you would like to make, please do so here. We value your thoughts.
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18. How long did it take you to complete this survey? ____ minutes
SV-2007-0003 OMB No. 1405-0158
FP 02 20 2007 Expiration Date: 02/29/2008
Estimated Burden: 10 Minutes
File Type | application/msword |
File Title | Pre-Program Survey |
Author | cinnamon |
Last Modified By | R. A. Ciupek |
File Modified | 2007-04-13 |
File Created | 2007-02-20 |