FEMA Form 064-0-5 End of Course Evaluation Form

FEMA FORM 064-0-5, OMB No. 1660-0032, Expiration:

Federal Emergency Management Agency/Department of Homeland Security

National Fire Academy End-of-Course Evaluation Form

Paperwork Reduction Act Notice

Public reporting burden for this form is estimated to be an average of 15 minutes per response. The burden includes the time for reviewing instructions, searching existing data sources, gathering and maintaining the needed data, and completing, reviewing and submitting the form. Although voluntary, you are not required to respond to this collection of information unless a valid OMB control number appears in the upper right corner of this form. Send comments regarding the accuracy of the burden estimate and any suggestions for reducing the burden to: Information Collections Management, Department of Homeland Security, Federal Emergency Management Agency, 500 C St. SW, Washington, DC 20472, Paperwork Reduction Project (1660-0032) NOTE: Please do not send your completed form to the above address.

DIRECTIONS FOR COMPLETING THIS FORM. Using a pen or pencil, please complete the course evaluation form by completely darkening the appropriate bubble for each item. Please fill the bubbles in. Do not sign or put your name on the form. All responses are confidential and will be reported ONLY in aggregate form.

Part I

Course Evaluation Data

Indicate the course information for this training and complete the bubble grid to indicate the course number for this training.

Course Code Number

Course Dates: ___/___/___ to ___/___/___

Course Name: _______________________________________________________________ 1 2 3 4 5 6 7 8 9 0

Course Length: ___2-day ___6-day ___10-day 1 2 3 4 5 6 7 8 9 0

Course Code: ___ R ___ N ___ F ___W ___ O 1 2 3 4 5 6 7 8 9 0

Location:___________________________________________________________________

To what extent do you agree with each of the following? Strongly Agree Neutral Disagree Strongly Does Not

The course… Agree Disagree Apply

1. increased my knowledge of this topic ___ ___ ___ ___ ___ ___

2. allowed enough time to complete assignments ___ ___ ___ ___ ___ ___

3. was well organized ___ ___ ___ ___ ___ ___

4. challenged me to learn more about this topic ___ ___ ___ ___ ___ ___

5. used effective teaching techniques (lecture, AVs, scenarios, Web) ___ ___ ___ ___ ___ ___

6. had a good balance of individual & group-based techniques ___ ___ ___ ___ ___ ___

7. helped me clarify my goals and professional expectations ___ ___ ___ ___ ___ ___

8. provided up-to-date information ___ ___ ___ ___ ___ ___

9. included useful web/technology resources for the material ___ ___ ___ ___ ___ ___

10. met my expectations ___ ___ ___ ___ ___ ___

The printed materials for this course…

1. were clear and easily readable ___ ___ ___ ___ ___ ___

2. supported class discussion ___ ___ ___ ___ ___ ___

3. will be a useful reference when I get back on the job ___ ___ ___ ___ ___ ___

The audiovisual materials for this course…

1. were of good technical quality ___ ___ ___ ___ ___ ___

Have you taken other NFA classes? To what extent did this course REQUIRE you to use…

A lot Some Not at all Does Not Apply

On campus: ___Yes ___No Internet & technology resources ____ ___ ____ ____

Off campus: ___Yes ___No NFIRS data ____ ___ ____ ____

Federal, local, or State resources ____ ___ ____ ____

GIS data ____ ___ ____ ____

How might this training class be improved and why is improvement needed? ________________________________________________________________________________________________________

________________________________________________________________________________________________________

What was the MOST beneficial aspect of this training class?

________________________________________________________________________________________________________

________________________________________________________________________________________________________

What was the LEAST beneficial aspect of this training class?

________________________________________________________________________________________________________

________________________________________________________________________________________________________

Before taking this class, was this material… How do you access information about NFA classes? (Check all that apply)

___ completely new to you? ___USFA/NFA Web page ___local departments

___ somewhat familiar to you? ___ other students ___information at conferences

___ very familiar to you? ___Other: (Specify)_____________________________

Would you recommend this course to someone? ___Yes ___No Because…___________________________________________

___________________________________________________________________________________________________________

Part II

Course Instructors/Overall Training

As you consider the instructors for this course, for Instructor #1, to what extent do you agree that…

Strongly Agree Neutral Disagree Strongly Does Not

Agree Disagree Apply

Instructor 1: Name:_______________________________

1. knew the material well ___ ___ ___ ___ ___ ___

2. regularly clarified course and assignment expectations ___ ___ ___ ___ ___ ___

3. encouraged independent thinking from students ___ ___ ___ ___ ___ ___

4. fostered a collaborative “team-based” learning experience ___ ___ ___ ___ ___ ___

5. supplemented course with helpful experience ___ ___ ___ ___ ___ ___

6. answered students’ questions clearly ___ ___ ___ ___ ___ ___

7. presented engaging lectures and discussion ___ ___ ___ ___ ___ ___

8. led the learning process without dominating it ___ ___ ___ ___ ___ ___

9. exhibited a positive attitude toward students ___ ___ ___ ___ ___ ___

10. conducted the class in a professional manner ___ ___ ___ ___ ___ ___

11. worked well with co-instructor ___ ___ ___ ___ ___ ___

12. is worth recommending to others ___ ___ ___ ___ ___ ___

Is there particular feedback you have regarding this instructor? (Be as specific as possible)___­­­­­­­­­­­­­­­­­­­­­­_____________________________

________________________________________________________________________________________________________________________

(PLEASE SKIP TO THE “This Training Experience” SECTION BELOW IF THERE WAS ONLY ONE INSTRUCTOR IN THIS COURSE.)

For Instructor #2: To what extent do you agree that… Strongly Agree Neutral Disagree Strongly Does Not

Agree Disagree Apply

Instructor 2: Name:__________________________________

1. knew the material well ___ ___ ___ ___ ___ ___

2. regularly clarified course and assignment expectations ___ ___ ___ ___ ___ ___

3. encouraged independent thinking from students ___ ___ ___ ___ ___ ___

4. fostered a collaborative “team-based” learning experience ___ ___ ___ ___ ___ ___

5. supplemented course with helpful experience ___ ___ ___ ___ ___ ___

6. answered students’ questions clearly ___ ___ ___ ___ ___ ___

7. presented engaging lectures and discussion ___ ___ ___ ___ ___ ___

8. led the learning process without dominating it ___ ___ ___ ___ ___ ___

9. exhibited a positive attitude toward students ___ ___ ___ ___ ___ ___

10. conducted the class in a professional manner ___ ___ ___ ___ ___ ___

11. worked well with co-instructor ___ ___ ___ ___ ___ ___

12. is worth recommending to others ___ ___ ___ ___ ___ ___

Is there particular feedback you have regarding this instructor? (Be as specific as possible)____­­­­­­­­­­­­­­­­­­­­­­_____________________________

____________________________________________________________________________________________________________

Considering the training OVERALL, to what extent do you agree that… Strongly Agree Neutral Disagree Strongly

Agree Disagree

This training experience…

1. will help me do my current job better ___ ___ ___ ___ ___

2. was consistent with my department’s training expectations ___ ___ ___ ___ ___

3. will be useful for a department the size of mine ___ ___ ___ ___ ___

4. will be applicable to my future work ___ ___ ___ ___ ___

5. included material helpful to my department’s prevention efforts ___ ___ ___ ___ ___

6. will help reduce the fire-related risks in my community ___ ___ ___ ___ ___

7. provided sufficient opportunities for networking ___ ___ ___ ___ ___

8. provided information my department can use when preparing for

or responding to an all-hazards and/or terrorist event ___ ___ ___ ___ ___

9. is worth recommending to others ___ ___ ___ ___ ___

(OFF-CAMPUS STUDENTS, PLEASE SKIP TO PART III ON NEXT PAGE)

Answer each of the following items as they apply to the class you have just completed. Indicate “Does Not Apply” where appropriate.

Satisfactory Unsatisfactory Does Not Apply

1. classroom and learning facilities _____ _____ ____

2. LRC _____ _____ ____

3. dormitory rooms _____ _____ ____

4. student center facilities _____ _____ ____

5. dining facilities _____ _____ ____

6. course registration and administrative details _____ _____ ____

7. workout/weight room facilities _____ _____ ____

Part III

Training Benefits

How do you think this course will help you in your job? (Check all that apply and note other ways as needed.)

General ___gave me material I will use daily ___showed how to increase my efficiency ___will help me use dept. resources better ___gave better idea of Federal, State, local resources ___increased my confidence, self-understanding ___gave me the big picture; brought me up to speed ___gave info for continued learning after training is over ___showed how to use public data sources ___showed value of identifying stakeholders ___helped to build/increase my professional network Leadership/Management ___provided new “people skills” ___will help me set department goals ___will make me a better manager/leader ___gave skills for interacting with subordinates ___taught me to delegate ___identified my leadership style(s) ___improved my administrative skills ___identified tools for handling departmental conflict ___increased my ability to see and set task priorities ___showed how to use data (e.g., NFIRS/GIS) for department planning OTHER:_______________________________________

Technical ___provided strategies for handling all-hazards incidents ___provided planning strategies for all-hazards prevention and preparedness illustrated use of “recognition-primed” model for decision making provided skills in fire protection systems and equipment design and operation ___Identified skills for managing training ___increased my knowledge of health and fire safety issues ___identified characteristics of at-risk audiences ___provided strategies and techniques for reaching at-risk audiences ___showed ways to develop interagency cooperation ___helped with adapting training for small departments and communities ___demonstrated the prevention side of EMS ___provided information for pre-incident planning ___provided tools for incident documentation OTHER:______________________________________________

How likely are you to re-apply to NFA for future training? ___Very likely ___Not sure; can’t say ___Somewhat likely ___Not likely to re-apply Do you plan to use the ACE (American Council on Education) credit recommendation associated with this course? ___Yes ___No ___I can’t say. I don’t know what ACE is.

When considering training, which of the following do you find most HELPFUL (#1 equals most helpful, etc.). ___Traditional classroom training ___Online training Combination of traditional and online training Which of the following do you PREFER. Rate in order of preference #1 equals “most,” #4 equals “least”). ___Self paced Webinars ___Online Discussion Board only ___Online Chat Room only

What are suggested topics for future NFA training classes? ___________________________________________________________

_____________________________________________________________________________________________________________

Additional comments? ___________________________________________________________________________________________

______________________________________________________________________________________________________________________________________________

Part IV

Student and Department Demographics

Location: Department/Organization. Please refer to the numerical codes listed below to indicate your Department or Organizational Location in the Location: Department/Organization Grid. For example, if your state is Maryland, which is code 24, fill in bubble number “2” in the first row and bubble number “4” in the second. If it is Alaska, fill in the bubble under the “0” for the first row and the bubble under the “1” for the second row.

Location: Department/Organization 0 1 2 3 4 5 6 7 8 9

(First digit of your state code) _ _ _ _ _ _ _ _ _ _

(Second digit of your state code) _ _ _ _ _ _ _ _ _

01___Alaska 11___Delaware 21___Kentucky 31___North Carolina 41___Oregon 51___Virginia

02___Alabama 12___Florida 22___Louisana 32___North Dakota 42___Pennsylvania 52___Virgin Islands

03___Arkansas 13___Georgia 23___Massachusetts 33___Nebraska 43___Puerto Rico 53___Vermont

04___Am. Samoa 14___Guam 24___Maryland 34___New Hampshire 44___Rhode Island 54___Washington

05___Arizona 15___Hawaii 25___Maine 35___New Jersey 45___South Carolina 55___Wisconsin

06___California 16___Iowa 26___Michigan 36___New Mexico 46___South Dakota 56___West Virginia

07___Colorado 17___Idaho 27___Minnesota 37___Nevada 47___Tennessee 57___Wyoming

08___Connecticut 18___Illinois 28___Missouri 38___New York 48___Trust Territories 58___Other

09___Canal Zone 19___Indiana 29___Mississippi 39___Ohio 49___Texas

10___District of Columbia 20___Kansas 30___Montana 40___Oklahoma 50___Utah

(1) Are you attending course as… __Career ___Volunteer ___Other ( 2) If you know it, please tell us your FDID#: _______(Bubble grid) 0 0 0 0 0 1 1 1 1 1 2 2 2 2 2 (3) Years of experience in 3 3 3 3 3 subject area related to course: 4 4 4 4 4 etc. through 9 ___less than 1 year in boxed area ___1 to 5 years ___6 to 10 years ___more than 10 years (4) Population currently served by your organization: __under 2,500 __10,000-24,999 __2,500-4,999 __25,000-49,999 __5,000-9,999 __50,000-99,000 __100,000 or more (5) Years of formal education: ___less than 9 ___AA degree ___HS graduation or equivalency ___Bachelor’s degree ___Some college ___ Master’s degree (6) Are you a fire instructor in your local jurisdiction? ___yes ___no

(7) What is your present position? __Firefighter __Bureau Chief __Driver/Operator __Division Chief __Specialist/Technician __Deputy Chief __Paramedic/EMT __Assistant Chief __Sergeant __Chief of Department __Lieutenant __Civilian Employee __Captain __Allied Professional __Battalion Chief __Other:____________ (8) What is your primary responsibility? __Command __Fire Prevention __Fire Suppression __Communications __EMS __Data Processing __Hazardous Materials __Public Education __Training/Instruction __Equipment Maint. __Investigation __Admin. Service __Inspection/Enforcement __Other:___________ (9) How long have you been in fire and emergency services? ___less than 1 year ___6 to 10 years ___1 to 5 years ___more than 10 years (10) What percent of your department are volunteer personnel? ___ none ___51-75% ___ 1-25% ___76-99% ___26-50% ___100%

Please answer the following questions: (1) Are you: __male (2) How old were you on your last birthday? 1 2 3 4 5 6 7 8 9 0 __female (First digit of your age) __ __ __ __ __ __ __ __ __ __ (Second digit of your age) __ __ __ __ __ __ __ __ __ __ (3) Please check the ethnicity that best applies to you. (4) Are you one or more of the following? ___Hispanic or Latino/Latina ___American Indian or Alaska Native ___Not Hispanic or Latino/Latina ___Asian ___Black or African-American ___Native Hawaiian or Pacific Islander ___White