Training Program Surveys for FDA State Tobacco Compliance Check Inspection Training Program and FDA/Center for Tobacco Products/Annual Program Coordinators' Conference

OMB No. 0910-0360

Exp. Date 00/00/0000

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U. S. Department of Health & Human Services

Food and Drug Administration

Center for Tobacco Products

1^st Annual FDA Program Coordinators’ Conference

Protecting Kids From Tobacco

Rockville, Maryland

S eptember 21–22, 2011

FDA Program Coordinator Training

EVALUATION

Please use blue ink, black ink, or pencil. Fill in each circle completely, and do not make any stray marks on the evaluation. For questions requesting written answers or comments, please print legibly using the space provided. Thank you for taking the time to complete this evaluation.

Please indicate your state’s contract experience with the FDA Tobacco Retail Inspection Program:

 2010-2011 contract years

 2011-2012 contract years

Example:

5 ●

4 ○

3 ○

2 ○

1 ○

Please use the scale listed below to evaluate the effectiveness of the overall conference. Completely fill in ONE circle for each question.

5 = Extremely 4 = Very 3 = Fairly 2 = Not Very 1 = Not Applicable

OVERALL CONFERENCE	5	4	3	2	1
How satisfied were you that the session topics were educational and informative?	○	○	○	○	○
How satisfied were you with the speakers’ abilities to meet the stated session objectives?	○	○	○	○	○
How satisfied were you with the conference materials?	○	○	○	○	○
How satisfied were you with the length of the presentations?	○	○	○	○	○
Prior to attending this conference, how motivated and engaged were you regarding the FDA inspection program?	○	○	○	○	○
After attending this conference, how motivated and engaged were you regarding the FDA inspection program?	○	○	○	○	○

Please provide comments below. Include comments on specific sessions and any questions you have ranked 3 or lower.

(over)

Please use the scale listed below to evaluate the effectiveness of the venue and facilities. Completely fill in ONE circle for each question.

5 = Extremely 4 = Very 3 = Fairly 2 = Not Very 1 = Not Applicable

VENUE/FACILITIES	5	4	3	2	1
How satisfied were you with the conference location?	○	○	○	○	○
How satisfied were you with audio/visual support of the conference program?	○	○	○	○	○

Please provide comments below. Include comments for any questions you have ranked 3 or lower.

Please use the scale listed below to evaluate the effectiveness of the registration process. Completely fill in ONE circle for each question.

5 = Extremely 4 = Very 3 = Fairly 2 = Not Very 1 = Not Applicable

REGISTRATION PROCESS	5	4	3	2	1
How satisfied were you with the overall registration process?	○	○	○	○	○
How satisfied were you with the travel instructions?	○	○	○	○	○
How helpful were the email notifications?	○	○	○	○	○

Please provide comments below. Include comments for any questions you have ranked 3 or lower.

Please provide your comments for the questions below:

12. Which session(s) was the most valuable to you?

13. Which session(s) was the least valuable to you?

14. What specific topic areas and in what presentation style(s) would you recommend for next year’s conference?

15. In what ways could this year’s conference improved?

16. Please list any additional comments.

Thank you for your feedback!

If you are unable to return this form at the end of the conference, please fax or email your evaluation by October 6, 2011, to:

Chris Dang • Seamon Corporation • Fax: 301-577-5261 • Email: cdang@seamoncorporation.com