On LIne Survey,, Cover Page

Attachment D:
Cover Page of the Online Survey

Hello!

You’ve been asked to complete a survey about your recent experience in an online or technology-based learning program offered by [fill Grantee Name]. To compensate you for your time, you will receive a gift valued at $15 for completing the survey. Just follow the instructions at the end of the survey to redeem your payment.

This survey is being conducted as part of an evaluation of online and technology-based learning programs. The evaluation is being carried out by Social Research Policy Associates for the Department of Labor, which provided funding for the program offered by [fill Grantee name].

The purpose of this study is to learn how well the program served your needs and whether you are satisfied with the program. Your opinions are very important to us, and we ask that you please take approximately 20 minutes to complete this survey.

Please note that your answers will be kept strictly confidential and will only be reported after combining your responses with those of all other respondents so that no individual person can be identified. In accordance with the Confidential Information Protection and Statistical Efficiency Act of 2002 (Title 5 of Public Law 107-347) and other applicable federal laws, your responses will not be disclosed in identifiable form without your informed consent. This voluntary information request has been approved by the Office of Management and Budget under OMB approval number 1205-XXXX, expiring xx/xx/xxxx. Without this approval, we would not be able to conduct this survey. Questions regarding any aspect of this survey may be directed to the U.S. Department of Labor, Employment and Training Administration, Room N-5641, 200 Constitution Avenue, N.W., Washington, D.C. 20210 (Paperwork Reduction Project 1205-XXXX).

As you read through the survey, answer each question with the response that best fits your experience or opinion. For most questions this means selecting the circle associated with your answer; for a small number of other questions it means filling in a blank.

If you have any questions or concerns about the survey, please feel free to contact the survey coordinator, Jill Leufgen, Social Policy Research Associates, by phone at (510) 763-1499 ext. 645 or email at [email protected]. If you have any questions about the evaluation, please contact the project manager, Kate Dunham, Social Policy Research Associates, at (510) 763-1499 ext. 635 or [email protected].

Thank you for your participation.

To begin please enter the access code included in your email or letter.

Access code: _________________