OCR Technical Assistance Evaluation Form

TECHNICAL ASSISTANCE EVALUATION FORM

U.S. Department of Education, Office for Civil Rights

Subject ____________________________________________

Date ____________________________________________

OCR Office ____________________________________________

Presenter ____________________________________________

Location ____________________________________________

Audience ____________________________________________

Please circle the appropriate number using the scale below:

Strongly Agree 5

Agree 4

Neither Agree nor Disagree 3

Disagree 2

Strongly Disagree 1

1. The main points of the presentation were clear

5 4 3 2 1

2. The presenter was well organized

5 4 3 2 1

3. Questions from the audience were addressed in a courteous and professional manner

5 4 3 2 1

4. The presentation expanded my knowledge of the subject area

5 4 3 2 1

Comments __________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

Name (optional) _______________________________________________________________­­­­_

Organization (optional) ________________________________________________________________

Paperwork Burden Statement

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless such collection displays a valid OMB control number. The valid OMB control number for this information collection is 1800-0011. The time required to complete this information collection is estimated to average 5 minutes, including the time to review instructions, search existing data resources, gather the data needed, and complete and review the information collection. If you have any comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: U.S. Department of Education, Washington, D.C. 20202-1100. If you have comments or concerns regarding the status of your individual submission of this form, write directly to the Office for Civil Rights, U.S. Department of Education, 400 Maryland Avenue, S.W., Washington, D.C. 20202-1100.