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OMB#: 1121-XXXX
Date of Expiration: XXXX
Participant Feedback
Unique ID Number: ________________________
In order to help OVC TTAC better serve the field, we would like 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. Answers to these questions will be reported after aggregating all responses. Although this survey is
completely voluntary, please note 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@icf.com.
EVENT:
SESSION:
LOCATION:
DATE(S):
PRESENTER(S):
Email: _________________________
Please rate your level of confidence in your ability to:
CONFIDENCE CAPACITY BUILDING MEASURE:
_______________
1.
2.
3.
4.
5.
6.
7.
[insert capacity-building objective].
[insert capacity-building objective].
[insert capacity-building objective].
[insert capacity-building objective].
[insert capacity-building objective].
[insert capacity-building objective].
[insert capacity-building objective].
KNOWLEDGE CAPACITY-BUILDING MEASURE:
_______________
8.
9.
10.
11.
12.
13.
14.
[insert capacity-building objective].
[insert capacity-building objective].
[insert capacity-building objective].
[insert capacity-building objective].
[insert capacity-building objective].
[insert capacity-building objective].
[insert capacity-building objective].
SKILLS CAPACITY-BUILDING MEASURE:
_______________
15.
16.
17.
18.
19.
20.
21.
[insert capacity-building objective].
[insert capacity-building objective].
[insert capacity-building objective].
[insert capacity-building objective].
[insert capacity-building objective].
[insert capacity-building objective].
[insert capacity-building objective].
Very Low
Low
Moderate
High
Very
High
Not
Applicable
1
1
1
1
1
1
1
2
2
2
2
2
2
2
3
3
3
3
3
3
3
4
4
4
4
4
4
4
5
5
5
5
5
5
5
NA
NA
NA
NA
NA
NA
NA
Very Low
Low
Moderate
High
Very
High
Not
Applicable
1
1
1
1
1
1
1
2
2
2
2
2
2
2
3
3
3
3
3
3
3
4
4
4
4
4
4
4
5
5
5
5
5
5
5
NA
NA
NA
NA
NA
NA
NA
Very Low
Low
Moderate
High
Very
High
Not
Applicable
1
1
1
1
1
1
1
2
2
2
2
2
2
2
3
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3
3
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4
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4
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4
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5
5
5
5
5
5
5
NA
NA
NA
NA
NA
NA
NA
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@icf.com or 9300 Lee Highway, Fairfax, VA 22031.
TRAINING
OMB#: 1121-XXXX
Date of Expiration: XXXX
Participant Feedback
Please indicate the extent to which you agree or disagree with the following statements.
Module [X]: _____________________________________
22. As a result of this module, I can…
23. As a result of this module, I can…
24. The learning objectives for this module were clearly stated.
Module [X]: _____________________________________
25. As a result of this module, I can…
26. As a result of this module, I can…
27. The learning objectives for this module were clearly stated.
Strongly
Disagree
Disagree
Neither
Agree nor
Disagree
Agree
Strongly
Agree
Not
Applicable
1
1
1
2
2
2
3
3
3
4
4
4
5
5
5
NA
NA
NA
Strongly
Disagree
Disagree
Neither
Agree nor
Disagree
Agree
Strongly
Agree
Not
Applicable
1
1
1
2
2
2
3
3
3
4
4
4
5
5
5
NA
NA
NA
Please indicate the extent to which you agree or disagree with the following statements.
PRESENTER/FACILITATOR 1: ___________________
28. The presenter demonstrated a comprehensive knowledge of the
subject.
29. The presenter clearly and logically presented the content.
30. The presenter responded well to questions and comments.
31. The presenter created a respectful environment for participants.
PRESENTER/FACILITATOR 2: ___________________
32. The presenter demonstrated a comprehensive knowledge of the
subject.
33. The presenter clearly and logically presented the content.
34. The presenter responded well to questions and comments.
35. The presenter created a respectful environment for participants.
OVERALL SESSION
36.
37.
38.
39.
40.
41.
42.
43.
44.
45.
46.
47.
48.
49.
50.
The session clearly addressed the learning objectives.
The session addressed the critical issues related to the topic(s).
The time allotted was adequate for the scope of material covered.
The session was well organized and clear.
The content was appropriate for my level of experience and
knowledge.
The resource materials (handouts, audiovisuals, PowerPoints)
enhanced the session.
The session increased my knowledge related to the topic(s).
The session increased my practical skills related to the topic(s).
I will be able to apply what I learned in my work.
The session improved my ability to serve victims.
The session improved my ability to reach underserved victims.
The session provided sufficient opportunity to network with others
in the field.
The small group activities enhanced my experience.
The session met my professional needs.
I am satisfied with the overall quality of the session.
Strongly
Disagree
Disagree
Neither
Agree nor
Disagree
Agree
Strongly
Agree
Not
Applicable
1
2
3
4
5
NA
1
1
1
2
2
2
3
3
3
4
4
4
5
5
5
NA
NA
NA
Strongly
Disagree
Disagree
Neither
Agree nor
Disagree
Agree
Strongly
Agree
Not
Applicable
1
2
3
4
5
NA
1
1
1
2
2
2
3
3
3
4
4
4
5
5
5
NA
NA
NA
Strongly
Disagree
Disagree
Neither
Agree nor
Disagree
Agree
Strongly
Agree
Not
Applicable
1
1
1
1
2
2
2
2
3
3
3
3
4
4
4
4
5
5
5
5
NA
NA
NA
NA
1
2
3
4
5
NA
1
2
3
4
5
NA
1
1
1
1
1
2
2
2
2
2
3
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NA
NA
NA
NA
NA
1
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5
NA
1
1
1
2
2
2
3
3
3
4
4
4
5
5
5
NA
NA
NA
TRAINING
OMB#: 1121-XXXX
Date of Expiration: XXXX
Participant Feedback
Following the training, what three steps will you take to better serve victims of crime?
a. ___________________________________________________________________________________
b. ___________________________________________________________________________________
c. ___________________________________________________________________________________
As a result of participating in this session, please rate your level of confidence in your likelihood to do any of the following:
51.
52.
53.
54.
55.
56.
57.
58.
59.
60.
61.
62.
63.
64.
65.
Share material with colleagues
Refer colleagues to other OVC TTAC events/resources
Train/educate others in content/skills learned
Pursue additional professional development
Develop/strengthen use of technology or infrastructure
Develop/strengthen collaborative or strategic relationships
Expand services to new victim populations
Expand types of services offered to victims
Strengthen administrative capacity to better serve victims of crime
(e.g., financial management, develop a board of directors)
Enact policy changes at my organization
Begin a new project or initiative
Change my management, leadership, or interpersonal
communication style
Strengthen evaluation or needs assessment activities
Network with other participants
Identify/pursue new funding resources
66. Implement/change financial procedures
67. Modify outreach/marketing activities
68. Develop/enhance vision, mission, or strategic plan
Very Low
Low
Moderate
High
Very
High
Not
Applicable
1
1
1
1
1
1
1
1
2
2
2
2
2
2
2
2
3
3
3
3
3
3
3
3
4
4
4
4
4
4
4
4
5
5
5
5
5
5
5
5
NA
NA
NA
NA
NA
NA
NA
NA
1
2
3
4
5
NA
1
1
2
2
3
3
4
4
5
5
NA
NA
1
2
3
4
5
NA
1
1
1
1
1
1
2
2
2
2
2
2
3
3
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3
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3
4
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4
5
5
5
5
5
5
NA
NA
NA
NA
NA
NA
Please specify any other actions you plan to take as a result of this session that are not listed in the table above.
____________________________________________________________________________________
69. Please explain in detail any ways this session improved your organization’s capacity to better serve victims of crime:
___________________________________________________________________________________
___________________________________________________________________________________
70. Would you recommend OVC TTAC to others?
□ Yes
□ No
71. What aspects of the session were most helpful and why?
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
72. What could be done differently to improve the session?
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
73. Do you have any other comments or suggestions?
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
TRAINING
OMB#: 1121-XXXX
Date of Expiration: XXXX
Participant Feedback
74. Following this session, what additional resource or trainings could OVC TTAC provide to support you and your organization?
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
75. How often have you engaged with OVC TTAC in the last 12 months? (Mark one.)
□ 1–3 times
□ 4–6 times
□ 7–9 times
□ 10+ times
76. Which of the following best describes your gender identity? (Mark one.)
□ Male
□ Female
□ Transgender Male
□ Transgender Female
□ Genderqueer/NonConforming/
Non-Binary
□ Two-Spirit
□ Not Listed (option to specify):
_________________________
77. Which of the following best describes your race/ethnicity? (Mark all that apply.)
□
□
□
□
American Indian or Alaska Native
Asian
Black/African American
Hispanic/Latino
□ Native Hawaiian or
Pacific Islander
□ White Non-Latino or
Caucasian
□ Not Listed (option to specify):
_________________________
78. Which of the following best describes the organization in which you work? (Mark all that apply.)
□
□
□
□
Community-Based/Grassroots
Criminal Justice Agency
Education
Faith-Based
□
□
□
□
Health/Mental Health Services
Human/Social Services
Legal Services
Legislation/Policymaking
□ Military
□ Research
□ Other (please specify):
_________________________
79. 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
Child Care
Compensation/Restitution
Counseling
Crisis Intervention
□ Criminal Justice System
Advocacy/Assistance
□ Housing/Shelter
□ Information/Referral
□ Medical/SANE/SART
□
□
□
□
Notification
Transportation
24-Hour Hotline
Other (please specify):
_________________________
80. 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
81. Which of the following best describes your primary role in your current position? (Mark all that apply.)
□ Direct Delivery/Front Line Staff
□ Management/Administrative Staff
□ Consultant/Trainer
□ Volunteer
□ Other (please specify):
_________________________
82. Which of the following best describes the population you serve? (Mark all that apply.)
□
□
□
□
National
State
Tribal
International, list country:
_________________________________
□ Local
□ Urban
□ Rural
□ Suburban
83. Please provide your city and state (i.e., location of organization or professional address).
___________________________________________________________________________________
84. Please list any marginalized or underserved populations you serve.
___________________________________________________________________________________
TRAINING
Participant Feedback
OMB#: 1121-XXXX
Date of Expiration: XXXX
___________________________________________________________________________________
___________________________________________________________________________________
Thank you for taking the time to complete this form and helping to improve OVC TTAC activities.
File Type | application/pdf |
Author | Field, Michael |
File Modified | 2022-06-16 |
File Created | 2022-06-16 |