FSA-2376ins

Instructions For Form FSA-2376

BORROWER TRAINING COURSE EVALUATION

Used by borrower training participants to rate the borrower training course completed. Trainee returns the form to the Vendor.

Vendors submit the original of the completed form in hard copy or facsimile to the appropriate USDA servicing office. Customers who have established electronic access credentials with USDA may electronically transmit this form to the USDA servicing office, provided that the customer submitting the form is the only person required to sign the transaction.

Features for transmitting the form electronically are available to those customers with access credentials only. If you would like to establish online access credentials with USDA, follow the instructions provided at the USDA eForms web site.

Part A is completed by the Vendor.

Part B is completed by the borrower.

Part A Items 1-6 are completed by the Vendor.

Fld Name / Item No.	Instruction
1 Course Title	Enter the title of the course.
2 Instructor’s Name	Enter the instructor’s name who conducted the course. If there was more than one instructor, enter the names of all instructors involved in conducting the course.
3 Vendor’s Name	Enter the vendor’s name.
4 Address of Vendor	Enter the business address of the vendor or organization.
5 Date of Training	Enter the dates the training course was held. If the course met for more than one session, enter the range of dates for the course. For example, if the course met once a week from December 1st through February 28th, indicate the range December 1, 20XX to February 28, 20XX in the space provided.
6 Location of Training	Enter the city and state where the training was held.

Part B Items 1-13B are completed by the borrower.

Fld Name / Item No.	Instruction
1-10 Select Appropriate Response	In items 1-10, circle the appropriate response to indicate the borrower’s opinion of the course.
11 Strong Points	Enter comments regarding the strong points of the course.
12 Weak Points	Enter comments regarding the weak points of the course.
13(a) Signature	Sign the form in the space provided; however, signing the form is optional. If more than one individual from an entity attended the course, each individual should complete a separate evaluation form.
13(b) Date	Enter the date the form was completed.

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