Form Approved
OMB No. 0920-XXXX
Exp. Date:
Public
reporting burden of this collection
of information is estimated to average 15
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.
An agency may not conduct or sponsor, and a person is not required
to respond to a collection of information unless it displays a
currently valid OMB control number. Send comments regarding this
burden estimate or any other aspect of this collection of
information, including suggestions for reducing this burden to
CDC/ATSDR Information Collection Review Office, 1600 Clifton Road
NE, MS D-24, Atlanta, Georgia 30333; ATTN: PRA (0920-XXXX).
Attachment L:
Parent Program Fidelity 6th Grade Session 1
Division of Violence Prevention
National Center for Injury Prevention and Control
Centers for Disease Control and Prevention
Parent Curriculum – 6th Grade, Session 1 – Why Do Parents Matter?
Attendance Log
Implementer Name: _____________________ Implementer ID: ___________________
School ID: _____________________________ Session ID: _______________________
Parent Name / Guardian Names |
Name of Child in Program |
Name of Child in Program |
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Parent Curriculum – 6th Grade, Session 1 – Why Do Parents Matter?
Session Log
Implementer Name: _____________________ Implementer ID: ___________________
School ID: _____________________________ Session ID: _______________________
Please indicate if you completed the following activities:
Activity |
Yes |
Yes w/ changes |
No |
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used |
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Please indicate if you experienced any of these challenges that interfered with implementing today’s session. Check all that apply.
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Describe any changes you made to the session activities.
Please think about today’s session and tell us your answers to the following questions. Circle the number that shows your opinion about each question.
How engaged were the parents in the session?
1 very bored
2
3 average
4
5 fully engaged
Please think about how well you think the session went today.
1 extremely poorly
2
3 average
4
5 exceptional
How well do you think the parents understood the session material?
1 Not at all
2 A little
3 A lot
4 Completely
How well did the session material fit into the allotted time period?
1 Session was too packed/not enough time to complete all activities
2 Session was somewhat packed/able to complete most but not all
3 Session was just right
4 Not enough material/session ended before class period completed
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | Wendy LiKamWa |
File Modified | 0000-00-00 |
File Created | 2021-01-30 |