RSN Evaluation Expert Form

RSN Expert Meeting/Convening Feedback

_{The Department of Education and the R}eform Support Network (RSN) are committed to providing quality technical assistance (TA) services. Please take a few minutes to provide feedback about your meeting experience to help us improve future TA and understand how TA benefits each State. The valid OMB control number for this information collection is xxx-xxxx.

Title: <insert title>

TA Date/Location: <date/location>

Goals and Anticipated Outcomes of TA:

• Insert TA goals

Please indicate the extent to which you agree that we met the following objectives.(maximum of 6 objectives)	Strongly Disagree	Disagree	Neither Agree nor Disagree	Agree	Strongly Agree
<insert objective 1>	1	2	3	4	5
<insert objective 2>	1	2	3	4	5
Please indicate your agreement with the following statement regarding this meeting.
I found the pre-work and background materials to be helpful in preparing me for this convening/meeting.	1	2	3	4	5
I was satisfied with the overall quality of the facilitation.	1	2	3	4	5
I am satisfied with the overall quality of this convening/meeting.	1	2	3	4	5
Attending this convening/meeting was a good use of my time.	1	2	3	4	5

1. What aspects of this convening/meeting were most relevant for your work and why?

2. How would you suggest changing future similar events to better achieve our goals?

3. What do you consider to be the key takeaways from the meeting?

4. Who was not represented at the meeting that has a critical perspective for this work?

5. What additional information or resources can you recommend on this topic?

6. Please note any additional comments or next steps:

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 5 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 xxxx-xxxx. Note: Please do not return the completed Customer Feedback Form to this address.

The valid OMB control number for this information collection is xxxx-xxxx.