Scholarship Program Applicant feedback form

SCHOLARSHIP PROGRAM

OMB# 1121-XXXX
Date of Expiration: XXXX

Applicant Feedback

In order to help OVC TTAC better serve the field, we are reaching out to you and other scholarship applicants to obtain your
feedback. We will protect the privacy of your information in accordance with the Federal Privacy Act, and we will protect the
confidentiality of your responses using procedures we have in place. Only members of the Needs Assessment and Evaluation Team
have access to information that could identify respondents. Answers to these questions will only be reported after aggregating all
responses, and the results will never identify you as an individual. Other participants, presenters, OVC staff, OVC TTAC staff, and
your employer will not have access to what you as an individual say. If you have any questions about this survey or the evaluation,
please contact [email protected].
Completing this feedback form is a requirement for scholarship recipients and voluntary for those not awarded scholarships. If
you were awarded a scholarship, please print your name in the space provided, so that your completion of this requirement can be
noted. The confidentiality of your responses is guaranteed.
Name:

Part I. OVC Scholarship Program
1.

How did you hear about the OVC Professional Development Scholarship Program? (Mark all that apply.)
□
□
□

□
□
□

OVC TTAC Web site
OVC TTAC event
OVC TTAC Listserv

2.

What month and year did you apply? ________________________

3.

Were you awarded an OVC Professional Development Scholarship?

Referred by another organization
Referred by a colleague or friend
Other(s): _____________________________

□ Yes

□ No

If yes, would you have been able to attend the desired training without a scholarship?
□ Yes

□ No

□ N/A

If no, were you or will you be able to attend the desired training without a scholarship?
□ Yes
4.

□ No

□ N/A

Would you recommend the OVC Professional Development Scholarship to others? □ Yes

□ No

Please indicate the extent to which you agree or disagree with the following statements.
APPLICATION PROCESS
5. OVC TTAC was responsive to my questions and needs.
6. The application was easy to complete.
7. The application instructions clearly explained the
eligibility requirements.
8. The application instructions clearly explained the
expenses covered under the program.
9. I was satisfied with the notification process.
10. I am satisfied with the overall application process by
OVC TTAC.

Strongly
Disagree

Disagree

Neither
Agree nor
Disagree

Agree

Strongly
Agree

Not
Applicable

1
1

2
2

3
3

4
4

5
5

NA
NA

1

2

3

4

5

NA

1

2

3

4

5

NA

1

2

3

4

5

NA

1

2

3

4

5

NA

11. What could have been done differently to improve the application process?

____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
12. Do you have any other comments or suggestions about the application process?

____________________________________________________________________________________
____________________________________________________________________________________
Paperwork Reduction Act Notice
Under the Paperwork Reduction Act, a person is not required to respond to a collection of information unless it displays a valid OMB control
number. The estimated average time to complete this form is 10 minutes. If you have comments regarding the accuracy of this estimate or
additional suggestions, please write to the OVC TTAC Evaluation Team at [email protected] or 9300 Lee Highway, Fairfax, VA 22031.

SCHOLARSHIP PROGRAM

OMB# 1121-0277
Date of Expiration: September 30, 2014

Applicant Feedback

13. Which of the following best describes the organization in which you work? (Mark all that apply.)





Community-Based/Grassroots
Criminal Justice Agency
Education
Faith-Based










Health Services
Human/Social Services
Legal Services
Legislation/Policymaking

Military
Research
Other (please specify):
__________________________

14. Which types of victim services do you provide for crime victims in your current position? (Mark all that apply.)






I do not provide direct services
Child Care
Compensation/Restitution
Counseling
Crisis Intervention











Criminal Justice System
Advocacy/Assistance
Medical Assistance
24-Hour Hotline
Information/Referral

Notification
Shelter
Transportation
Other (please specify):
__________________________

15. Which of the following best describes the number of years of experience you have in your field of work? (Mark one.)



Less than 3 years
3 to 5 years




6 to 10 years
More than 10 years

16. Which of the following best describes your primary role in your current position? (Mark all that apply.)



Direct Delivery/Front Line Staff
Management/Administrative Staff






Consultant/Trainer
Volunteer

Other (please specify):
_________________________

17. Which of the following best describes the population you serve? (Mark all that apply.)







National
State
Tribal
International, list country:
_______________________________



Local
 Urban
 Rural
 Suburban
Culturally specific population(s):__________________

Part II. Event Feedback
Only complete this section if you were awarded a scholarship. Please note this section of the feedback form is NOT
confidential in order to help the OVC TTAC scholarship team make future decisions regarding similar events.
18. Please provide the following information about the event you attended that was funded by scholarship funds:
Event Title: ________________________________________________________________________________________
Date(s): ____________________________

Location: __________________________________________________

Please indicate the extent to which you agree or disagree with the following statements.
Strongly
Disagree

Disagree

Neither
Agree nor
Disagree

Agree

Strongly
Agree

Not
Applicable

19. The event addressed the critical issues related to the topic(s).

1

2

3

4

5

NA

20. The material was appropriate for my level of experience and knowledge.

1

2

3

4

5

NA

21. The event increased my knowledge related to the topic(s).

1

2

3

4

5

NA

22. The event increased my practical skills related to the topic(s).

1

2

3

4

5

NA

23. I will be able to apply what I learned in my work.

1

2

3

4

5

NA

24. The event improved my ability to serve victims.

1

2

3

4

5

NA

25. The event improved my ability to reach underserved victims.

1

2

3

4

5

NA

26. The event improved my ability to collaborate with others in the field.

1

2

3

4

5

NA

27. The event met my goals.

1

2

3

4

5

28. I am satisfied with the overall quality of the event.

1

2

3

4

5

NA
NA

Overall Event

SCHOLARSHIP PROGRAM

OMB# 1121-0277
Date of Expiration: September 30, 2014

Applicant Feedback

29. At which type of event was the training held? (Mark all that apply.)
□
□

National conference
State/regional conference

□
□

Local conference
Other:___________________________________

30. Do you plan to do any of the following as a result of attending this event? (Mark all that apply.)
□ Train colleagues in content/skills learned at the event
(required)
□ Share materials with colleagues
□ Refer colleagues to other OVC TTAC events/resources
□ Enact policy changes at my organization
□ Begin a new project or initiative
□ Strengthen evaluation or needs assessment activities
□ Modify outreach/marketing activities
□ Change my management or leadership style

□
□
□
□
□
□
□
□

Expand services to new victim populations
Expand types of services offered to victims
Expand capacity/frequency of services to victims
Pursue additional professional development
Network with other participants
Strengthen collaborative relationships with other orgs
Identify/pursue new funding resources
Other(s): _____________________________________

Please explain:
____________________________________________________________________________________________________

____________________________________________________________________________________
____________________________________________________________________________________
31. Do you have any other comments or suggestions about the event?

____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________

Thank you for taking the time to complete this form and helping to improve OVC TTAC activities.