FSA-2376 Borrower Training Course Evaluation

Conservation Loan Program - Direct Loan Making

FSA2376_071231V01

Conservation Loan Program - Direct Loan Making

OMB: 0560-0268

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This form is available electronically. Form Approved – OMB No. 0560-0237

FSA-2376 U.S. DEPARTMENT OF AGRICULTURE

(12-31-07) Farm Service Agency


BORROWER TRAINING COURSE EVALUATION


PART A – TO BE COMPLETED BY VENDOR

1. Course Title

     

2. Instructor’s Name

     

3. Vendor’s Name

     

4. Vendor’s Address

     

5. Date of Training Course

     

6. Location

     



PART B – TO BE COMPLETED BY BORROWER

1. The topics covered in class were

helpful to me in my business………

Yes

 

Partially

 

No

 

11. Comments on the strong points of the course:

     

2. The coverage of this subject matter

was……………………………..…..…

Excellent

 

Sufficient

 

Poor

 

3. The suitability of the instruction

material was…………..……...…….….

Excellent

 

Sufficient

 

Poor

 

4. The level of the course was……….….

Too

Advanced

 

Appropriate

 

Too

Easy

 

5. The length of the course was………..

Too Long

 

Appropriate

 

Too

Short

 

6. The amount of outside work was……..

Too Much

 

Appropriate

 

Too

Little

 

12. Comments on the weak points of the course:

     

7. The instructor was………………..…..

Excellent

 

Good

 

Poor

 

8. The facilities were…………..……….…

Excellent

 

Good

 

Poor

 

9. Will you continue to take training

Courses in production and financial

management if not required?..............

Yes

 

Maybe

 

No

 

10. Would you recommend this

course to other individuals?.............

Yes

 

No

Comment

 

No

 

13(a). Signature (Optional)


13(b). Date

     

After you have completed this evaluation, please it to the Vendor.

NOTE:

The following statements are made in accordance with the Privacy Act of 1974 (5 USC 552a): the Farm Service Agency (FSA) is authorized by the Consolidated Farm and Rural Development Act, as amended (7 USC 1921 et seq.), or other Acts, and the regulations promulgated thereunder, to solicit the information requested on its application forms. The information requested is necessary for FSA to determine eligibility for credit or other financial assistance, service your loan, and conduct statistical analyses. Supplied information may be furnished to other Department of Agriculture agencies, the Internal Revenue Service, the Department of Justice or other law enforcement agencies, the Department of Defense, the Department of Housing and Urban Development, the Department of Labor, the United States Postal Service, or other Federal, State, or local agencies as required or permitted by law. In addition, information may be referred to interested parties under the Freedom of Information Act (FOIA), to financial consultants, advisors, lending institutions, packagers, agents, and private or commercial credit sources, to collection or servicing contractors, to credit reporting agencies, to private attorneys under contract with FSA or the Department of Justice, to business firms in the trade area that buy chattel or crops or sell them for commission, to Members of Congress or Congressional staff members, or to courts or adjudicative bodies. Disclosure of the information requested is voluntary. However, failure to disclose certain items of information requested, including your Social Security Number or Federal Tax Identification Number, may result in a delay in the processing of an application or its rejection.


According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0560-0237. The time required to complete this information collection is estimated to average 30 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. RETURN THIS COMPLETED FORM TO YOUR COUNTY FSA OFFICE.

The U.S. Department of Agriculture (USDA) prohibits discrimination in all its program and activities on the basis of race, color, national origin, age, disability, and where applicable, sex, marital status, familial status, parental status, religion, sexual orientation, genetic information, political beliefs, reprisal, or because all or part of an individual’s income is derived from any public assistance program. (Not all prohibited bases apply to all programs.) Persons with disabilities who require alternative means for communication of program information ( Braille, large print, audiotape, etc.) should contact USDA’s TARGET Center at (202) 720-2600 (voice and TDD). To file a complaint of Discrimination, write to USDA, Director, Office of Civil Rights, 1400 Independence Avenue, SW., Washington, DC 20250-9410, or call (800) 795-3272 (voice) or (202) 720-6382 (TDD). USDA is an equal opportunity provider and employer.

File Typeapplication/msword
File TitleThis form is available electronically
Authorliz.ashton
Last Modified Bymaryann.ball
File Modified2010-07-12
File Created2010-07-12

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