OCO Customer Feedback Form

U .S. Department of Education

Customer Feedback Form

Events, Conferences, Meetings

We at the U. S. Department of Education are committed to serving our customers. We value your opinion and request that you complete this short form at the end of this event. Your opinion will help us improve our conferences meetings, and presentations. Thank you for your opinions and ideas.

Please circle the number on the scale

that reflects your review.

How Are We Doing? Name of Event: Date:	Poor	Fair	Average	Very Good	Outstanding	Not Applicable
Please rate the event you participated in by assessing the:
1. Coordination/Logistics (Did you receive enough notice)?	1	2	3	4	5	NA
2. Relevance to your needs	1	2	3	4	5	NA
3. Content Quality (Informative, meets your needs)?	1	2	3	4	5	NA
4. Agenda Topics (Related to event)?	1	2	3	4	5	NA

Comments:

How can we improve this event? ________________________________________________________________

____________________________________________________________________________________________________________________________________________________________________________________________________________________________________

What other feedback would you like to provide the Department? __________________________________

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

This form is anonymous; however, if you would like to be added to our listserv, to receive information updated about the U.S. Department of Education please feel free to provide your name and email address below or you may sign on electronically at: http://www.ed.gov/parents/academic/help/partner-listserv.html

Name: _______________________________________________________________________________

Organization: _______________________________________________________________________________

Email: _______________________________________________________________________________

Public Burden Statement

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless such collection displays a valid OMB control number. Public reporting burden for this collection of information is estimated to average 7 minutes per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. The obligation to respond to this collection is voluntary. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the U.S. Department of Education, 400 Maryland Ave., SW, Washington, DC 20202-4536 or email [email protected] and reference the OMB Control Number 1880-0542. Note: Please do not return the completed OCO Customer Feedback Form to this address.