Training by Request Participant Feedback form

O MB#: 1121-XXXX Training by Request

Date of Expiration: XXXX Participant Feedback

Unique ID Number: ________________________

In order to help OVC TTAC better serve the field, we are reaching out to obtain your feedback. We will protect the privacy of your information in accordance with the Federal Privacy Act, and we will protect the confidentiality of your responses using procedures we have in place. Only members of the Evaluation Team have access to information that could identify respondents. Answers to these questions will only be reported after aggregating all responses, and the results will never identify you as an individual. Other participants/users, consultants/presenters, OVC staff, OVC TTAC staff, and your employer will not have access to what you as an individual say. Although this survey is completely voluntary, please not that completing this form is a requirement for receiving CEU credit. If you have any questions about this survey or the evaluation, please contact TTACEval@icfi.com.

EVENT: SESSION:

LOCATION: DATE(S):

PRESENTER(S):

If you would be willing to participate in a brief followup survey in 3 months, please provide your e-mail: _________________________

Please indicate the extent to which you agree or disagree with the following statements.

Module [X]: _____________________________________	Strongly Disagree	Disagree	Neither Agree nor Disagree	Agree	Strongly Agree	Not Applicable
As a result of this module, I can…	1	2	3	4	5	NA
As a result of this module, I can…	1	2	3	4	5	NA
The learning objectives for this module were clearly stated.	1	2	3	4	5	NA
Module [X]: _____________________________________	Strongly Disagree	Disagree	Neither Agree nor Disagree	Agree	Strongly Agree	Not Applicable
As a result of this module, I can…	1	2	3	4	5	NA
As a result of this module, I can…	1	2	3	4	5	NA
The learning objectives for this module were clearly stated.	1	2	3	4	5	NA

Please indicate the extent to which you agree or disagree with the following statements.

PRESENTER/FACILITATOR 1: ___________________	Strongly Disagree	Disagree	Neither Agree nor Disagree	Agree	Strongly Agree	Not Applicable
The presenter demonstrated a comprehensive knowledge of the subject.	1	2	3	4	5	NA
The presenter clearly and logically presented the content.	1	2	3	4	5	NA
The presenter responded well to questions and comments.	1	2	3	4	5	NA
The presenter created a respectful environment for participants.	1	2	3	4	5	NA
PRESENTER/FACILITATOR 2: ___________________	Strongly Disagree	Disagree	Neither Agree nor Disagree	Agree	Strongly Agree	Not Applicable
The presenter demonstrated a comprehensive knowledge of the subject.	1	2	3	4	5	NA
The presenter clearly and logically presented the content.	1	2	3	4	5	NA
The presenter responded well to questions and comments.	1	2	3	4	5	NA
The presenter created a respectful environment for participants.	1	2	3	4	5	NA

OVERALL SESSION	Strongly Disagree		Disagree	Neither Agree nor Disagree	Agree	Strongly Agree	Not Applicable
The session clearly addressed the learning objectives.	1	2		3	4	5	NA
The session addressed the critical issues related to the topic(s).	1	2		3	4	5	NA
The time allotted was adequate for the scope of material covered.	1	2		3	4	5	NA
The session was well organized and clear.	1	2		3	4	5	NA
The material was appropriate for my level of experience and knowledge.	1	2		3	4	5	NA
The resource materials (handouts, audiovisuals, PowerPoints) enhanced the session.	1	2		3	4	5	NA
The session increased my knowledge related to the topic(s).	1	2		3	4	5	NA
The session increased my practical skills related to the topic(s).	1	2		3	4	5	NA
I will be able to apply what I learned in my work.	1	2		3	4	5	NA
The session improved my ability to serve victims.	1	2		3	4	5	NA
The session improved my ability to reach underserved victims.	1	2		3	4	5	NA
The session provided sufficient opportunity to network with others in the field.	1	2		3	4	5	NA
The small group activities enhanced my experience.
The session met my goals.	1	2		3	4	5	NA
I am satisfied with the overall quality of the session.	1	2		3	4	5	NA

30. Do you plan to do any of the following as a result of participating in this session? (Mark all that apply.)

□ Share material with colleagues □ Expand services to new victim populations

□ Refer colleagues to other OVC TTAC events/resources □ Expand types of services offered to victims

□ Train/educate others in content/skills learned □ Expand capacity/frequency of services to victims

□ Enact policy changes at my organization □ Strengthen evaluation or needs assessment activities

□ Begin a new project or initiative □ Network with other participants

□ Change my management, leadership, or □ Identify/pursue new funding resources

interpersonal communication style □ Implement/change financial procedures

□ Pursue additional professional development □ Modify outreach/marketing activities

□ Develop/strengthen use of technology or infrastructure □ Develop/enhance vision, mission, or strategic plan

□ Develop/strengthen collaborative or strategic relationships □ Other(s): _____________________________________

Please explain in detail any of these activities: _______________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

31. Would you recommend OVC TTAC to others? □ Yes □ No

32. What aspects of the session were most helpful and why?

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

33. What could be done differently to improve the session?

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

34. Do you have any other comments or suggestions?

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

35. Which of the following best describes the organization in which you work? (Mark all that apply.)

□ Community-Based/Grassroots □ Health/Mental Health Services □ Military

□ Criminal Justice Agency □ Human/Social Services □ Research

□ Education □ Legal Services □ Other (please specify):

□ Faith-Based □ Legislation/Policymaking _________________________

36. Which types of victim services do you provide for crime victims in your current position? (Mark all that apply.)

□ I do not provide direct services □ Criminal Justice System □ Notification

□ Child Care Advocacy/Assistance □ Transportation

□ Compensation/Restitution □ Housing/Shelter □ 24-Hour Hotline

□ Counseling □ Information/Referral □ Other (please specify):

□ Crisis Intervention □ Medical/SANE/SART _________________________

37. Which of the following best describes the number of years of experience you have in your current field of work? (Mark one.)

□ Less than 3 years □ 3 to 5 years □ 6 to 10 years □ More than 10 years

38. Which of the following best describes your primary role in your current position? (Mark all that apply.)

□ Direct Delivery/Front Line Staff □ Consultant/Trainer □ Other (please specify):

□ Management/Administrative Staff □ Volunteer _________________________

39. Which of the following best describes the population you serve? (Mark all that apply.)

□ National □ Local

□ State □ Urban

□ Tribal □ Rural

□ International, list country: □ Suburban

_________________________________ □ Culturally specific populations(s): ________________________

Thank you for taking the time to complete this form and helping to improve OVC TTAC activities.

Paperwork Reduction Act Notice

Under the Paperwork Reduction Act, a person is not required to respond to a collection of information unless it displays a valid OMB control number. The estimated average time to complete this form is 15 minutes. If you have comments regarding the accuracy of this estimate or additional suggestions, please write to the OVC TTAC evaluation team at TTACEval@icfi.com or 9300 Lee Highway, Fairfax, VA 22031.