Meeting/Forum Evaluation

Office of Surface Mining Reclamation and Enforcement
Meeting/Forum Evaluation (electronic version)

OMB 1029-0114
Expires 03/31/2011

Thank you for participating in this meeting/forum presented by the Office of Surface Mining Reclamation and Enforcement. Your response to this
survey will assist us in evaluating and improving our performance as required by the Government Performance and Results Act. Your response is
voluntary.
OSMRE Use Only

MEETING/FORUM TITLE:
MEETING/FORUM DATE:
Please rate your overall satisfaction with the meeting/forum (1 very unsatisfied - 5 very satisfied)
Which topics/sessions
were the most useful to
you?
Additional topics or
speakers that should
have been included?
Do you have topic
suggestions for future
meeting/forums?
How could the format
be improved?

Other comments about
the meeting/forum?
Please rate your overall satisfaction with the facilities (1 very unsatisfied - 5 very satisfied)
Comments about the
facilities?
Comments about the
accomodations (if
provided by OSMRE)?
Return this evaluation form by pressing the "Submit by Email” button or; print the form and mail or fax to:
Print Form

Office of Surface Mining Reclamation and Enforcement
Technology Management Division
1999 Broadway, Suite 3320
Denver, CO 80202-3050

Submit by Email

Fax (303)293-5058

PAPERWORK REDUCTION ACT STATEMENT
The Paperwork Reduction Act of 1995 (44 U.S.C. 3501) requires us to inform you that: Federal Agencies may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays
a currently valid OMB control number. This information is being collected to better serve you in the future as part of the Office of Surface Mining Reclamation and Enforcement's performance of its responsibilities under
the Government Performance and Results Act. Your response is voluntary.
Public reporting burden for this form is estimated to average five minutes per response, including time for reviewing instructions, gathering and maintaining data, and completing and reviewing the form. Direct comments
regarding the burden estimate or any other aspect of this form to the Information Collection Clearance Officer, Office of Surface Mining Reclamation and Enforcement, Room 202 SIB, 1951 Constitution Ave, NW,
Washington, D.C. 20240.