Screen Print of Electronic Version

Mediation Services Participant Questionnaire - 0003B - Electronic Screen Print.pdf

Program Evaluation Instruments - Environmental Conflict Resolution Services Participant Questionnaires (Five Instruments)

Screen Print of Electronic Version

OMB: 3320-0003

Document [pdf]
Download: pdf | pdf
Mediation	Participant	Evaluation	-	Agreement	Seeking
OMB	Number:	3320-0004
Approval	Expiry	Date:	02/28/2015
The	U.S.	Institute	for	Environmental	Conflict	Resolution	requests	your	assistance	in	evaluating	this	process.	As	a
part	of	this	evaluation	we	ask	the	various	participants	who	have	been	involved	in	this	project	to	provide	us	with
information	about	their	experience.	The	data	compiled	will	be	used	to	improve	future	mediation	and	facilitation
processes.	The	average	estimated	reporting	burden	for	this	questionnaire	is	18	minutes.	This	estimate	includes
time	for	reviewing	the	instructions,	gathering	the	data	needed,	completing,	and	reviewing	the	questionnaire.	Send
comments	regarding	this	burden	estimate	or	any	other	aspect	of	this	collection	of	information,	including
suggestions	for	reducing	this	burden,	to	the	Institute.	The	Institute	will	not	report	information	from	this	evaluation
in	a	way	that	respondents	or	their	organizations	can	be	identified.	Moreover,	the	identity	of	individual	respondents
will	be	kept	confidential	and	will	not	be	disclosed.	The	Office	of	Management	and	Budget	(OMB)	number	that	is
displayed	on	the	cover	is	currently	valid	and	authorizes	this	collection	of	information.	

Base	Survey:	Mediation	Participant	Evaluation	-	Agreement	Seeking
1.	Please	indicate	the	extent	to	which	agreement	was	reached.	TO	ANSWER	THIS
QUESTION,	THINK	ABOUT	WHAT	IT	WAS	THAT	THE	GROUP	WAS	CHARGED	TO	COME	UP
WITH	AT	THE	END	OF	THIS	COLLABORATIVE	PROCESS.
The	term	“AGREEMENT”	applies	to	the	written	or	unwritten	agreement	reached	by
participants	in	the	process,	including	plans,	proposals/recommendations,	procedures,
collaborative	decisions	to	work	together	and	settlements.
Select	only	one	
Agreement	reached	on	all	key	issues
Agreement	on	most	key	issues
Agreement	on	some	key	issues
No	agreement	on	any	key	issues,	but	progress	was	made	towards	addressing	the	issues	or	resolving	the
conflict.
No	agreement,	we	ended	the	process	without	making	much	progress.

Use	the	space	below	if	you	would	like	to	elaborate	on	your	response:	

Base	Survey:	Mediation	Participant	Evaluation	-	Agreement	Seeking
2.	Using	the	scale	below,	rate	the	following	statement	regarding	the	agreement	(as	referred
to	in	#1).	

2.	Please	select	one:	
CLICK	HERE	IF	AGREEMENT	WAS	REACHED
CLICK	HERE	IF	NOT	APPLICABLE	(I.E.,	NO	AGREEMENT	WAS	REACHED)

Base	Survey:	Mediation	Participant	Evaluation	-	Agreement	Seeking
2.	Using	the	scale	below,	rate	the	following	statement	regarding	the	agreement	(as	referred
to	in	#1).	

2a.	The	extent	to	which	you	feel	that	the	agreement	reached	takes	account	of	your	key
interests.	
0	-	Not	at	all

5	-	Moderately

10	-	Completely

2b.	The	extent	to	which	the	agreement	reached	will	effectively	solve	the	problem/resolve	the
conflict.	
0	-	Not	at	all

5	-	Moderately

10	-	Completely

2c.	The	extent	to	which	you	are	confident	the	agreement	can	be	implemented.	
0	-	Not	at	all

5	-	Moderately

10	-	Completely

Base	Survey:	Mediation	Participant	Evaluation	-	Agreement	Seeking
3.	If	an	assisted	collaborative	process	had	not	been	used,	what	would	have	been	the	most
likely	approach	to	working	to	address	this	issue(s)?	(click	only	one):	
a.	Unassisted	negotiation
b.	Judicial	settlement	conference
c.	Litigation
d.	Lobbying	or	working	to	achieve	legislative	action
e.	Rulemaking
f.	Arbitration
g.	Administrative	proceeding	(e.g.,	agency	appeals	process,	contested	process	hearing,	agency	order)
h.	Wait	for	a	better	time	to	take	action
i.	Don't	know
j.	Other

If	you	selected	Other,	please	specify:	

Base	Survey:	Mediation	Participant	Evaluation	-	Agreement	Seeking
4.	Please	consider	how	the	collaborative	process	you	completed	compares	with	the
alternative	that	you	identified	in	the	previous	question.	Select	the	option	that	reflects
your	best	estimate	of	the	costs	of	the	collaborative	process	compared	to	the	alternative.	(click
only	one):	
The	collaborative	process	was	likely	less	expensive
The	collaborative	process	was	likely	more	expensive
The	costs	of	the	collaborative	process	were	likely	about	the	same	as	the	costs	of	the	alternative

Base	Survey:	Mediation	Participant	Evaluation	-	Agreement	Seeking
5.	Were	the	benefits	from	the	process	worth	the	time	and	money	you/your	organization
invested?	(click	only	one):	
Yes
No
Don't	Know

Base	Survey:	Mediation	Participant	Evaluation	-	Agreement	Seeking
6.	Using	the	scale	below,	how	do	you	think	the	collaborative	process	you	completed	would
compare	with	the	alternative	that	you	selected	in	the	question	3?	

6.	Please	select	one:	
CLICK	HERE	IF	APPLICABLE	(YOU	DID	NOT	SELECT	"DON'T	KNOW"	FOR	QUESTION	3)
CLICK	HERE	IF	NOT	APPLICABLE	(YOU	SELECTED	"DON'T	KNOW"	FOR	QUESTION	3)

Base	Survey:	Mediation	Participant	Evaluation	-	Agreement	Seeking
6.	Using	the	scale	from	the	previous	page,	how	do	you	think	the	collaborative	process	you
completed	would	compare	with	the	alternative	that	you	selected	in	the	question	3?	

6a.	The	results	of	the	collaborative	process	better	served	my	interests.	
0	-	Not	at	all

5	-	Moderately

10	-	Completely

6b.	The	results	of	the	collaborative	process	are	less	likely	to	be	challenged.	
0	-	Not	at	all

5	-	Moderately

10	-	Completely

6c.	The	participants	are	more	likely	to	be	able	to	work	together	in	the	future	on	matters
related	to	this	case	or	project.	
0	-	Not	at	all

5	-	Moderately

10	-	Completely

6d.	The	collaborative	process	we	participated	in	more	effectively	addressed	the	issues	or
resolved	the	conflict.	
0	-	Not	at	all

5	-	Moderately

10	-	Completely

6e.	The	collaborative	process	we	participated	in	led	or	will	lead	to	a	more	informed	public
action	/	decision.	
0	-	Not	at	all

5	-	Moderately

10	-	Completely

Base	Survey:	Mediation	Participant	Evaluation	-	Agreement	Seeking
7.	Using	the	scale	from	the	previous	page,	please	rate	the	extent	to	which	the	following
conditions	were	in	place	(1)	when	the	process	began	and	(2)	as	a	result	of	the	process.	

7a.	Before	the	process	began,	the	participants	were	able	to	work	together	cooperatively.
Leave	blank	if	don't	know.	
0	-	Do	not	agree	at	all

5	-	Moderately	agree

10	-	Completely	agree

7a.	As	a	result	of	the	process,	the	participants	were	able	to	work	together	cooperatively.
Leave	blank	if	don't	know.	
0	-	Do	not	agree	at	all

5	-	Moderately	agree

10	-	Completely	agree

7b.	Before	the	process	began,	the	participants	trusted	each	other.	Leave	blank	if	don't	know.

0	-	Do	not	agree	at	all

5	-	Moderately	agree

10	-	Completely	agree

7b.	As	a	result	of	the	process,	the	participants	trusted	each	other.	Leave	blank	if	don't	know.

0	-	Do	not	agree	at	all

5	-	Moderately	agree

10	-	Completely	agree

7c.	Before	the	process	began,	the	other	parties	had	legitimate	interests	that	needed	to	be
addressed.	
0	-	Do	not	agree	at	all

5	-	Moderately	agree

10	-	Completely	agree

7c.	As	a	result	of	the	process,	the	other	parties	had	legitimate	interests	that	needed	to	be
addressed.	
0	-	Do	not	agree	at	all

5	-	Moderately	agree

10	-	Completely	agree

Base	Survey:	Mediation	Participant	Evaluation	-	Agreement	Seeking
8.	Please	identify	the	key	factors	important	to	your	decision	whether	to	participate	in	this
facilitated/mediated	process.	(please	select	the	MOST	important	one):	
a.	Ability	to	have	confidential	discussions
b.	Fairness	of	process
c.	Necessary	parties	would	participate
d.	Sufficient	trust	of	other	parties
e.	Prospects	for	reaching	agreement
f.	Initial	conversations	(sometimes	called	situation	or	conflict	assessments)	with	a	process
facilitator/mediator
g.	A	change	in	factors	outside	my	control	(e.g.,	court	order,	agency	decision)
h.	Other.

If	you	selected	g	or	h,	please	specify:	

Base	Survey:	Mediation	Participant	Evaluation	-	Agreement	Seeking
8.	Please	identify	the	key	factors	important	to	your	decision	whether	to	participate	in	this
facilitated/mediated	process.	(please	select	the	SECOND	MOST	important	one):	
a.	Ability	to	have	confidential	discussions
b.	Fairness	of	process
c.	Necessary	parties	would	participate
d.	Sufficient	trust	of	other	parties
e.	Prospects	for	reaching	agreement
f.	Initial	conversations	(sometimes	called	situation	or	conflict	assessments)	with	a	process
facilitator/mediator
g.	A	change	in	factors	outside	my	control	(e.g.,	court	order,	agency	decision)
h.	Other.

If	you	selected	g	or	h,	please	specify:	

Base	Survey:	Mediation	Participant	Evaluation	-	Agreement	Seeking
9.	Using	the	scale	provided,	please	rate	your	level	of	agreement	with	the	following:	

9a.	I	had	the	resources	(e.g.,	time,	money)	needed	to	participate	effectively	in	the	process.	

0	-	Do	not	agree	at	all

5	-	Moderately	agree

10	-	Completely	agree

9b.	The	participants,	as	a	group,	felt	they	were	appropriately	engaged	in	designing	the
process.	Leave	blank	if	"Don't	Know"	or	"Not	Applicable".	
0	-	Do	not	agree	at	all

5	-	Moderately	agree

10	-	Completely	agree

9c.	I	was	involved	as	needed	in	selecting	the	mediator(s)/facilitator(s).	Leave	blank	if	"Don't
Know"	or	"Not	Applicable"	
0	-	Do	not	agree	at	all

5	-	Moderately	agree

10	-	Completely	agree

9d.	As	a	result	of	early	conversations	with	the	mediator/facilitator	we	were	able	to	make	an
informed	decision	on	whether	a	collaborative	process	could	help	us	meet	our	goals.	Leave
blank	if	"Don't	Know"	or	"Not	Applicable".	
0	-	Do	not	agree	at	all

5	-	Moderately	agree

10	-	Completely	agree

9e.	The	participants,	as	a	group,	represented	all	affected	concerns.	
0	-	Do	not	agree	at	all

5	-	Moderately	agree

10	-	Completely	agree

9f.	The	participants	had	sufficient	authority	to	make	commitments	on	behalf	of	their
organizations.	
0	-	Do	not	agree	at	all

5	-	Moderately	agree

10	-	Completely	agree

9g.	The	participants	continued	to	be	engaged	as	long	as	their	involvement	was	needed.	
0	-	Do	not	agree	at	all

5	-	Moderately	agree

10	-	Completely	agree

9h.	The	process	helped	you	gain	a	better	understanding	of	the	other	participants’	views	and
perspectives.	
0	-	Do	not	agree	at	all

5	-	Moderately	agree

10	-	Completely	agree

9i.	The	process	helped	you	identify	and	focus	on	the	key	issues	that	had	to	be	addressed.	
0	-	Do	not	agree	at	all

5	-	Moderately	agree

10	-	Completely	agree

9j.	The	participants,	as	a	group,	sought	options	or	solutions	that	met	the	common	needs	of	all
participants.	
0	-	Do	not	agree	at	all

5	-	Moderately	agree

10	-	Completely	agree

9k.	The	process	enabled	participants	to	be	civil	to	each	other.	
0	-	Do	not	agree	at	all

5	-	Moderately	agree

10	-	Completely	agree

Base	Survey:	Mediation	Participant	Evaluation	-	Agreement	Seeking
10.	Using	the	scale	provided,	please	rate	your	level	of	agreement	with	the	following:	

10a.	I	had	sufficient	access	to	relevant	information	I	needed	in	order	to	participate	effectively
in	this	collaborative	process.	
0	-	Do	not	agree	at	all

5	-	Moderately	agree

10	-	Completely	agree

10b.	Information	technology	tools	(e.g.,	a	project	web	site	was	used	to	share	information,
spatial	analysis	and	decision	support	tools	were	used)	were	effectively	used.	Leave	blank	if
Not	Applicable.	
0	-	Do	not	agree	at	all

5	-	Moderately	agree

10	-	Completely	agree

10c.	I	gained	useful	information	as	a	result	of	participation	in	the	process.	
0	-	Do	not	agree	at	all

5	-	Moderately	agree

10	-	Completely	agree

10d.	The	quality	of	the	information	used	was	sufficient	to	support	the	group’s	discussions	and
decision	making.	
0	-	Do	not	agree	at	all

5	-	Moderately	agree

10	-	Completely	agree

Base	Survey:	Mediation	Participant	Evaluation	-	Agreement	Seeking
11.	Using	the	scale	provided,	please	rate	the	following	for	each	of	the	mediators/facilitators
involved	in	this	process.	Please	identify	each	mediator/facilitator	by	entering	their	initials	in
the	space	provided,	and	then	rate	each	statement	for	each	mediator/facilitator.	

11.	Initials	of	mediator:	

11a.	The	mediator/facilitator	kept	us	on	track	and	helped	us	find	ways	to	move	forward
constructively.	
0	-	Do	not	agree	at	all

5	-	Moderately	agree

10	-	Completely	agree

11b.	The	mediator/facilitator	helped	us	manage	technical	discussions	efficiently.	Leave	blank
if	Not	Applicable.	
0	-	Do	not	agree	at	all

5	-	Moderately	agree

10	-	Completely	agree

11c.	The	mediator/facilitator	dealt	with	all	participants	in	a	fair	&	unbiased	manner,	and
made	sure	that	no	one	dominated	the	process.	
0	-	Do	not	agree	at	all

5	-	Moderately	agree

10	-	Completely	agree

11d.	I	trusted	the	mediator/facilitator.	
0	-	Do	not	agree	at	all

5	-	Moderately	agree

10	-	Completely	agree

11e.	I	was	comfortable	with	the	level	of	confidentiality	in	my	discussions	with	the
mediator/facilitator.	Leave	blank	if	Not	Applicable.	
0	-	Do	not	agree	at	all

5	-	Moderately	agree

10	-	Completely	agree

11f.	The	mediator/facilitator	made	sure	that	my	views	and	perspectives	were	considered	in
the	process.	
0	-	Do	not	agree	at	all

5	-	Moderately	agree

10	-	Completely	agree

11g.	The	mediator/facilitator	helped	the	participants	test	the	practicality	of	the	options	under
discussion.	
0	-	Do	not	agree	at	all

5	-	Moderately	agree

10	-	Completely	agree

11h.	The	mediator/facilitator	was	helpful	in	documenting	our	work.	Leave	blank	if	Not
Applicable	(e.g.,	no	agreement).	
0	-	Do	not	agree	at	all

5	-	Moderately	agree

10	-	Completely	agree

11i.	On	reflection,	this	was	the	right	mediator/facilitator	to	guide	the	process.	
0	-	Do	not	agree	at	all

5	-	Moderately	agree

10	-	Completely	agree

Base	Survey:	Mediation	Participant	Evaluation	-	Agreement	Seeking
11.	Using	the	scale	provided,	please	rate	the	following	for	each	of	the	mediators/facilitators
involved	in	this	process.	Please	identify	each	mediator/facilitator	by	entering	their	initials	in
the	space	provided,	and	then	rate	each	statement	for	each	mediator/facilitator.	

11.	Initials	of	mediator:	

11a.	The	mediator/facilitator	kept	us	on	track	and	helped	us	find	ways	to	move	forward
constructively.	
0	-	Do	not	agree	at	all

5	-	Moderately	agree

10	-	Completely	agree

11b.	The	mediator/facilitator	helped	us	manage	technical	discussions	efficiently.	Leave	blank
if	Not	Applicable.	
0	-	Do	not	agree	at	all

5	-	Moderately	agree

10	-	Completely	agree

11c.	The	mediator/facilitator	dealt	with	all	participants	in	a	fair	&	unbiased	manner,	and
made	sure	that	no	one	dominated	the	process.	
0	-	Do	not	agree	at	all

5	-	Moderately	agree

10	-	Completely	agree

11d.	I	trusted	the	mediator/facilitator.	
0	-	Do	not	agree	at	all

5	-	Moderately	agree

10	-	Completely	agree

11e.	I	was	comfortable	with	the	level	of	confidentiality	in	my	discussions	with	the
mediator/facilitator.	Leave	blank	if	Not	Applicable.	
0	-	Do	not	agree	at	all

5	-	Moderately	agree

10	-	Completely	agree

11f.	The	mediator/facilitator	made	sure	that	my	views	and	perspectives	were	considered	in
the	process.	
0	-	Do	not	agree	at	all

5	-	Moderately	agree

10	-	Completely	agree

11g.	The	mediator/facilitator	helped	the	participants	test	the	practicality	of	the	options	under
discussion.	
0	-	Do	not	agree	at	all

5	-	Moderately	agree

10	-	Completely	agree

11h.	The	mediator/facilitator	was	helpful	in	documenting	our	work.	Leave	blank	if	Not
Applicable	(e.g.,	no	agreement).	
0	-	Do	not	agree	at	all

5	-	Moderately	agree

10	-	Completely	agree

11i.	On	reflection,	this	was	the	right	mediator/facilitator	to	guide	the	process.	
0	-	Do	not	agree	at	all

5	-	Moderately	agree

10	-	Completely	agree

Base	Survey:	Mediation	Participant	Evaluation	-	Agreement	Seeking
11.	Using	the	scale	provided,	please	rate	the	following	for	each	of	the	mediators/facilitators
involved	in	this	process.	Please	identify	each	mediator/facilitator	by	entering	their	initials	in
the	space	provided,	and	then	rate	each	statement	for	each	mediator/facilitator.	

11.	Initials	of	mediator:	

11a.	The	mediator/facilitator	kept	us	on	track	and	helped	us	find	ways	to	move	forward
constructively.	
0	-	Do	not	agree	at	all

5	-	Moderately	agree

10	-	Completely	agree

11b.	The	mediator/facilitator	helped	us	manage	technical	discussions	efficiently.	Leave	blank
if	Not	Applicable.	
0	-	Do	not	agree	at	all

5	-	Moderately	agree

10	-	Completely	agree

11c.	The	mediator/facilitator	dealt	with	all	participants	in	a	fair	&	unbiased	manner,	and
made	sure	that	no	one	dominated	the	process.	
0	-	Do	not	agree	at	all

5	-	Moderately	agree

10	-	Completely	agree

11d.	I	trusted	the	mediator/facilitator.	
0	-	Do	not	agree	at	all

5	-	Moderately	agree

10	-	Completely	agree

11e.	I	was	comfortable	with	the	level	of	confidentiality	in	my	discussions	with	the
mediator/facilitator.	Leave	blank	if	Not	Applicable.	
0	-	Do	not	agree	at	all

5	-	Moderately	agree

10	-	Completely	agree

11f.	The	mediator/facilitator	made	sure	that	my	views	and	perspectives	were	considered	in
the	process.	
0	-	Do	not	agree	at	all

5	-	Moderately	agree

10	-	Completely	agree

11g.	The	mediator/facilitator	helped	the	participants	test	the	practicality	of	the	options	under
discussion.	
0	-	Do	not	agree	at	all

5	-	Moderately	agree

10	-	Completely	agree

11h.	The	mediator/facilitator	was	helpful	in	documenting	our	work.	Leave	blank	if	Not
Applicable	(e.g.,	no	agreement).	
0	-	Do	not	agree	at	all

5	-	Moderately	agree

10	-	Completely	agree

11i.	On	reflection,	this	was	the	right	mediator/facilitator	to	guide	the	process.	
0	-	Do	not	agree	at	all

5	-	Moderately	agree

10	-	Completely	agree

Base	Survey:	Mediation	Participant	Evaluation	-	Agreement	Seeking
12.	Using	the	scale	provided,	please	rate	your	agreement	with	the	following	statement.	

12a.	I	had	communication	with	the	mediator/facilitator	that	did	not	include	all	parties,	and
helped	me	resolve	an	issue	important	for	advancing	the	process.	Leave	blank	if	Not
Applicable.	
0	-	Do	not	agree	at	all

5	-	Moderately	agree

10	-	Completely	agree

12a.	If	yes,	please	elaborate	on	how	the	communication	contributed	to	advancing	the	process:

Base	Survey:	Mediation	Participant	Evaluation	-	Agreement	Seeking
13.	Using	the	scale	provided,	please	rate	your	agreement	with	the	following	statements:	

13a.	I	would	recommend	this	type	of	process	to	colleagues	in	a	similar	situation.	
0	-	Do	not	agree	at	all

5	-	Moderately	agree

10	-	Completely	agree

13b.	We	could	not	have	progressed	as	far	using	any	other	approach	of	which	I	am	aware.	
0	-	Do	not	agree	at	all

5	-	Moderately	agree

10	-	Completely	agree

13c.	The	group	could	not	have	progressed	as	far	without	the	help	of	a	mediator/facilitator.	

0	-	Do	not	agree	at	all

5	-	Moderately	agree

10	-	Completely	agree

Base	Survey:	Mediation	Participant	Evaluation	-	Agreement	Seeking
14.	Overall,	what	did	this	collaborative	process	accomplish?	(please	select	the	MOST
important	one):	
a.	A	potentially	costly	or	divisive	dispute	was	likely	avoided.
b.	An	impasse	(stalemate)	was	broken.
c.	A	crisis	was	likely	averted.
d.	Conflict	didn’t	escalate.
e.	Costly	or	protracted	litigation	was	likely	avoided.
f.	Relationships	among	parties	in	this	process	were	improved.
g.	The	process	resulted	in	timely	decisions	and	outcomes.
h.	Nothing	was	accomplished.
i.	The	process	made	the	issues	or	dispute	worse.

Base	Survey:	Mediation	Participant	Evaluation	-	Agreement	Seeking
14.	Overall,	what	did	this	collaborative	process	accomplish?	(please	select	the	SECOND
MOST	important	one):	
a.	A	potentially	costly	or	divisive	dispute	was	likely	avoided.
b.	An	impasse	(stalemate)	was	broken.
c.	A	crisis	was	likely	averted.
d.	Conflict	didn’t	escalate.
e.	Costly	or	protracted	litigation	was	likely	avoided.
f.	Relationships	among	parties	in	this	process	were	improved.
g.	The	process	resulted	in	timely	decisions	and	outcomes.
h.	Nothing	was	accomplished.
i.	The	process	made	the	issues	or	dispute	worse.

Base	Survey:	Mediation	Participant	Evaluation	-	Agreement	Seeking
15.	From	your	perspective,	what	will	be	the	effects	(e.g.,	impacts	or	benefits)	of	the	progress	made?	PLEASE	RANK
THE	MOST	IMPORTANT	EFFECTS	(E.G.,	1ST	MOST	IMPORTANT,	2ND	MOST	IMPORTANT).	PLEASE	ALSO
BRIEFLY	DESCRIBE	THE	EFFECTS.	

15a.	Natural	resources	and	environmental	conditions	

15a.	Please	briefly	describe	the	effects.

15b.	Historic	and	cultural	resources	

15b.	Please	briefly	describe	the	effects.	

15c.	Community	and	social	conditions	

15c.	Please	briefly	describe	the	effects.	

15d.	Economic	conditions	

15d.	Please	briefly	describe	the	effects.	

15e.	Recreational	uses	

15e.	Please	briefly	describe	the	effects.	

15f.	Other	

15f.	Please	briefly	describe	the	effects.	

Base	Survey:	Mediation	Participant	Evaluation	-	Agreement	Seeking
16.	What	is	your	top	suggestion	on	how	this	collaborative	process	could	have	been	improved?
PLEASE	WRITE	"NONE"	IF	YOU	FEEL	THIS	PROCESS	COULD	NOT	HAVE	BEEN
IMPROVED.	

Base	Survey:	Mediation	Participant	Evaluation	-	Agreement	Seeking
17.	Which	category	best	describes	the	interest	or	organization	you	represented	in	this
process?	SELECT	THE	MOST	APPROPRIATE	OPTION	ONLY.	
a.	Federal	Government
b.	State	Government
c.	Local/County/Regional	Government
d.	Tribal	Government
e.	Environmental/Conservation
f.	Recreational
g.	Industrial/Resource	Extraction
h.	Business/Commercial
i.	Community	or	Private	Citizen	(e.g.,	neighborhood	association,	local	resident)
j.	Special	Advocacy	Interests
k.	Other

If	you	selected	j	or	k,	please	specify:	

Base	Survey:	Mediation	Participant	Evaluation	-	Agreement	Seeking
18.	Please	use	the	space	below	for	any	additional	comments	you	would	like	to	make.	


File Typeapplication/pdf
File Modified2024-03-13
File Created2024-02-06

© 2024 OMB.report | Privacy Policy