Form 1 2019 Nonprofit Forum on-site meeting feedback survey

OMB#: 0925-0648 Exp Date: 05/2021

Public reporting burden for this collection of information is estimated to average 10 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency 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. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: NIH, Project Clearance Branch, 6705 Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA (0925-0648). Do not return the completed form to this address.

1. What is your overall evaluation of the NINDS Nonprofit Forum? (Check one)

( ) 5–Outstanding ( ) 4–Good ( ) 3–Satisfactory ( ) 2–Less than Satisfactory ( ) 1–Poor

2. What segments of the program were of most value to you? (Select up to three.)

• Orientation

• Cell Therapy

• Gene Therapy and Gene Editing

• Issues in Data Collection and Storage

• Big Data: How to Address Custom Needs

• Meet the Program Directors/Division Directors

• Breakout Sessions

• Motivating the Next Generation of Researchers

• Neuroethics

• Featured Success Stories

3. What segments of the program were of least value to you? (Select up to three.)

• Orientation

• Cell Therapy

• Gene Therapy and Gene Editing

• Issues in Data Collection and Storage

• Big Data: How to Address Custom Needs

• Meet the Program Directors/Division Directors

• Breakout Sessions

• Motivating the Next Generation of Researchers

• Neuroethics

• Featured Success Stories

4. How satisfied were you with the topics overall?

( ) 5–Very Satisfied ( ) 4–Satisfied ( ) 3–Neutral ( ) 2–Dissatisfied ( ) 1–Very Dissatisfied

5. Which topics would you like to see on the agenda for the next Forum?

6. How likely are you to attend the next Forum? (Note: The dates for the 2020 Forum have not yet been confirmed.)

( ) 5–Very Likely ( ) 4–Likely ( ) 3–Neutral ( ) 2–Unlikely ( ) 1–Very Unlikely

7. Would you recommend the Forum to others?

( ) Yes ( ) No

8. What is your overall evaluation of the Forum facilities and location?

( ) 5–Outstanding ( ) 4–Good ( ) 3–Satisfactory ( ) 2–Less than Satisfactory ( ) 1–Poor

9. How did you learn about the Forum?

( ) E-mail from NINDS ( ) Other (please specify)

10. Additional comments/suggestions regarding the Forum: