Form NRC Form 840 NRC Form 840 Non-NRC Participant Course Feedback Form

NRC FORM 840
(MM-YYYY)

U.S. NUCLEAR REGULATORY COMMISSION

APPROVED BY OMB: NO. 3150-XXXX

EXPIRES: (MM/DD/YYYY)

Estimated burden per response to comply with this voluntary collection request: 12 minutes.
Send comments regarding burden estimate to the FOIA, Privacy, and Information Collections
Branch (T-5 F53), U. S. Nuclear Regulatory Commission, Washington, DC 20555-0001, or by
e-mail to Infocollects.Resource@nrc.gov, and to the Desk Officer, Office of Information and
Regulatory Affairs, NEOB-10202, (3150-xxxx), Office of Management and Budget,
Washington, DC 20503. If a means used to impose an information collection does not
display a currently valid OMB control number, the NRC may not conduct or sponsor, and a
person is not required to respond to, the information collection.

NON-NRC PARTICIPANT
COURSE FEEDBACK FORM
NRC students should complete the
evaluation form located in ilearn

Course Title:

Start Date: (MM/DD/YYYY)

Location:

End Date: (MM/DD/YYYY)

1. The course met all stated objectives.
Strongly Agree

Agree

Neither Agree nor Disagree

Disagree

Strongly Disagree

2. The course allowed enough time to learn the subject matter that was covered.
Strongly Agree

Agree

Neither Agree nor Disagree

Disagree

Strongly Disagree

Disagree

Strongly Disagree

Disagree

Strongly Disagree

3. The course presentation was logically organized and easy to follow.
Strongly Agree

Agree

Neither Agree nor Disagree

4. The course participant handouts supported the learning experience.
Strongly Agree

Agree

Neither Agree nor Disagree

5. I feel that I had sufficient prior knowledge and experience to prepare me for this course.
Strongly Agree

Agree

Neither Agree nor Disagree

Disagree

Strongly Disagree

6. I feel that I expect what I learned to improve my current or future job performance.
Strongly Agree

Agree

Neither Agree nor Disagree

Disagree

Strongly Disagree

Disagree

Strongly Disagree

Disagree

Strongly Disagree

Disagree

Strongly Disagree

Disagree

Strongly Disagree

Disagree

Strongly Disagree

Disagree

Strongly Disagree

7. I feel that I am overall satisfied with the course.
Strongly Agree

Agree

Neither Agree nor Disagree

8. The Instructional Method(s) used was (were) an effective way for me to learn.
Strongly Agree

Agree

Neither Agree nor Disagree

9. The Instructor was knowledgeable about the subject matter.
Strongly Agree

Agree

Neither Agree nor Disagree

10. The Instructor clearly stated the course objectives.
Strongly Agree

Agree

Neither Agree nor Disagree

11. The Instructor presented material in a manner that was easily understood.
Strongly Agree

Agree

Neither Agree nor Disagree

12. The Instructor asked questions to periodically check for learning.
Strongly Agree
NRC FORM 840 (MM-YYYY)

Agree

Neither Agree nor Disagree

Page 1 of 2

NRC FORM 840

U.S. NUCLEAR REGULATORY COMMISSION

(MM-YYYY)

NON-NRC PARTICIPANT
COURSE FEEDBACK FORM
NRC students should complete the
evaluation form located in ilearn

APPROVED BY OMB: NO. 3150-XXXX

EXPIRES: (MM/DD/YYYY)

Estimated burden per response to comply with this voluntary collection request: 12 minutes.
Send comments regarding burden estimate to the FOIA, Privacy, and Information Collections
Branch (T-5 F53), U. S. Nuclear Regulatory Commission, Washington, DC 20555-0001, or by
e-mail to Infocollects.Resource@nrc.gov, and to the Desk Officer, Office of Information and
Regulatory Affairs, NEOB-10202, (3150-xxxx), Office of Management and Budget,
Washington, DC 20503. If a means used to impose an information collection does not
display a currently valid OMB control number, the NRC may not conduct or sponsor, and a
person is not required to respond to, the information collection.

13. The Instructor encouraged course participation and interactions among participants.
Strongly Agree

Agree

Neither Agree nor Disagree

Disagree

Strongly Disagree

Disagree

Strongly Disagree

14. The Instructor helped participants relate the material to their job.
Strongly Agree

Agree

Neither Agree nor Disagree

15. What were the most valuable aspects of this course?

16. What were the least valuable aspects of this course?

17. Do you have any recommendations to improve any aspect of the course?

NRC FORM 840 (MM-YYYY)

Page 2 of 2