Form MA-1078A MARAD CVSSA Customer Program Survey

M ARAD CVSSA Program Survey (Voluntary)

A federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person be subject to a penalty for failure to comply with a collection of information subject to the requirements of the Paperwork Reduction Act unless that collection of information displays a current valid OMB Control Number. The OMB Control Number for this information collection is 2133-0546. Public reporting for this collection of information is estimated to be approximately 15 minutes per response, including the time for reviewing instructions, completing and reviewing the collection of information. All responses to this collection of information are voluntary. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to: Information Collection Clearance Officer, Maritime Administration, MAR-390, 1200 New Jersey Avenue, SE, Washington, DC 20590.

Company Name (Optional):
Date:
Objective:	The objective of this survey is to receive feedback on services provided to the MARAD Certified CVSSA Training Providers from MARAD’s CVSSA Program Manager. This survey is by no means required; it is purely voluntary. The results of the survey will be reported as aggregate information and solely used to improve MARAD’s CVSSA Training Provider Certification program. Upon completing the survey, you may email the form to CVSSA-MARAD@dot.gov. Thank you for considering.

1. The MARAD CVSSA Program Manager who evaluated my application was courteous and professional.

☐ Strongly Agree

☐ Agree

☐ Disagree

☐ Strongly Disagree

☐ N/A

2. The MARAD CVSSA Program Manager who assessed my application was knowledgeable.

☐ Strongly Agree

☐ Agree

☐ Disagree

☐ Strongly Disagree

☐ N/A

3. The MARAD CVSSA Program Manager provided quality feedback in progressing my application towards certification or with MARAD program audit non-conformities.

☐ Strongly Agree

☐ Agree

☐ Disagree

☐ Strongly Disagree

☐ N/A

4. I was satisfied with the timeliness of the MARAD CVSSA Program Manager.

☐ Strongly Agree

☐ Agree

☐ Disagree

☐ Strongly Disagree

☐ N/A

5. Overall I was satisfied with the service I received the MARAD CVSSA Program Manager

☐ Strongly Agree

☐ Agree

☐ Disagree

☐ Strongly Disagree

☐ N/A

6. 
   

   Comments:

   Provide additional comments relevant to the management of the MARAD CVSSA Program.

Form MA-1078A 09-2017