B All Grantee Meeting Individual Session Feeback

OMB Control No. 0915-0212

Expiration Date: 07/31/2021

2019 MIECHV All Grantee Meeting - Individual Session Feedback Form

February 26 – 28, 2019

Public Burden Statement: 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. The OMB control number for this project is 0915-0212. Public reporting burden for this collection of information is estimated to average .03 hours per response, including the time for reviewing instructions, searching existing data sources, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to HRSA Reports Clearance Officer, 5600 Fishers Lane, Room 18N136B, Rockville, Maryland, 20857.

Please select your affiliation

☐ MIECHV State Region or Territory

☐ Tribal Home Visiting Program

☐ Other

Please select the role that most closely aligns with your responsibilities related to the MIECHV project.

Grantee Lead/Director/Coordinator Grantee Data/Evaluation Staff Grantee Program Staff/Consultant Grantee Grants Management/Fiscal Staff Home Visitor ECCS Coordinator/Staff

Federal Staff/Partner Model Developer National TA Provider Speaker Other

Please rate each session using the scale listed below

Not at all Somewhat Very much

Very little Quite a bit

Please indicate the degree (enter rating 1, 2, 3, 4 or 5 in the box) to which the Plenary or Breakout session...	Achieved intended objectives	Met your needs	Provided new information	Allotted time for questions and and/or quality discussion	Was well organized, engaging and effectively presented	Speaker(s) demonstrated topic expertise	Provided information you can apply to practice and/or enhanced your professional expertise
Plenary: Date, title and presenter
Breakout Session: Date, title & presenter

What is one thing that you like best about the session:

What is one thing that you would change:

Other comments: