Work Plan participant Feedback form

WORK PLAN

OMB# 1121-XXXX
Date of Expiration: XXXX

Participant Feedback

In order to help OVC TTAC better serve the field, we are reaching out to you and other participants 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. Your participation is completely voluntary. If you have any questions about
this survey or the evaluation, please contact [email protected].
EVENT: pre-printed information

SESSION: _ pre-printed information

LOCATION: pre-printed information

DATE(S): pre-printed formation

PRESENTER(S): pre-printed information
LEARNING OBJECTIVES: pre-printed information

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

PRESENTER/FACILITATOR 1 ___________________
1.

2.

3.
4.

The presenter demonstrated a comprehensive knowledge of the
subject./The facilitator helped the meeting to stay on-track with the
scheduled agenda.
The presenter clearly and logically presented the content./The
facilitator managed the discussion well, allowing and encouraging
multiple people to share feedback.
The presenter/facilitator responded well to questions and
comments.
The presenter/facilitator created a respectful environment for
participants.

OVERALL SESSION
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.

The session clearly addressed the learning objectives/stated
objectives. (See above for objectives.)
The session addressed the critical issues related to the topic(s).
The time allotted was adequate for the scope of material covered.
The session was well organized and clear.
The material was appropriate for my level of experience and
knowledge.
The resource materials (handouts, audiovisuals, manual) enhanced
the session.
The session increased my knowledge related to the topic(s).
The session increased my practical skills related to the topic(s).
I will be able to apply what I learned in my work.
The session will enable me to serve victims better.
The session will enable me to better reach underserved victims.
The session will help build more collaboration among participants.
There was sufficient opportunity to network with others in the field.
The xxx[small group activities/discussion, etc.] enhanced my
experience.
The session met my goals.
I am satisfied with the overall quality of the session.

Strongly
Disagree

Disagree

Neither
Agree nor
Disagree

Agree

Strongly
Agree

Not
Applicable

1

2

3

4

5

NA

1

2

3

4

5

NA

1

2

3

4

5

NA

1

2

3

4

5

NA

Strongly
Disagree

Disagree

Neither
Agree nor
Disagree

Agree

Strongly
Agree

Not
Applicable

1

2

3

4

5

NA

1
1
1

2
2
2

3
3
3

4
4
4

5
5
5

NA
NA
NA

1

2

3

4

5

NA

1

2

3

4

5

NA

1
1
1
1
1
1
1

2
2
2
2
2
2
2

3
3
3
3
3
3
3

4
4
4
4
4
4
4

5
5
5
5
5
5
5

NA
NA
NA
NA
NA
NA
NA

1

2

3

4

5

NA

1
1

2
2

3
3

4
4

5
5

NA
NA

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.

WORK PLAN

OMB# 1121-XXXX
Date of Expiration: XXXX

Participant Feedback

21. Do you plan to do any of the following as a result of attending this OVC TTAC session? (Mark all that apply.)
□
□
□
□
□
□
□
□

Share materials with colleagues
Refer colleagues to other OVC TTAC events/resources
Train colleagues in content/skills learned at the event
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: ________________________________________________________________________________________

____________________________________________________________________________________
□ Yes

22. Would you recommend OVC TTAC to others?

□ No

23. What aspects of the session were most helpful and why?

____________________________________________________________________________________
____________________________________________________________________________________
24. What could have been done differently to create a better session?

____________________________________________________________________________________
____________________________________________________________________________________
25. Do you have any other comments or suggestions?

____________________________________________________________________________________
____________________________________________________________________________________
26. 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):
__________________________

27. 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):
__________________________

28. 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

29. 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):
__________________________

30. 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):__________________

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