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pdfInstrument 5: Feedback Form for Community of Learning Events
OMB Control No.: XXXX-XXXX
Expiration Date: xx/xx/xxxx
THE PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13) Public reporting burden for this collection of information is
estimated to average 9 minutes per response, including the time for reviewing instructions, gathering and maintaining the data
needed, 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.
Study of Coordination of Tribal TANF and Child Welfare Services
FEEDBACK FORM for Community of Learning Events
Learning Community Event:_______________________________________ Date:_______________
Dear participant:
We would appreciate your feedback so that we can assess the usefulness of this event and to improve
the quality and relevance of future events of this kind. Completion of this feedback form is voluntary.
All information gathered from this form will be kept private and individual responses will not be
reported. This form will take about 9 minutes to complete.
Please indicate the degree to which you agree with the following statements about the [name of event] that
you just participated in.
Strongly
Strongly
Agree
Agree
Neutral
Disagree Disagree
NA
The topics were well-organized
The depth of topic coverage was
excellent
In general, the presenter/facilitator
was effective
The content covered is relevant to me
and my Tribe [or Tribal organization]
The information presented was
culturally appropriate
Overall, the quality of discussions and
dialogue was high
The opportunities to interact during
the event were plentiful
Overall, I was satisfied with the
information-sharing that took place
during the event
Participating in this event was
beneficial
Overall, I was satisfied with this event
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OMB Control No.: XXXX-XXXX
Expiration Date: xx/xx/xxxx
Please make any comments/suggestions in the relevant spaces below.
If the event was beneficial to you, please describe how so?
Please comment on what we could do to improve Learning Community events in order for them
to be more beneficial to you and your tribe/tribal organization:
Thank you, your feedback is very much appreciated!
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| File Type | application/pdf |
| Author | Pirkko Ahonen |
| File Modified | 2012-05-10 |
| File Created | 2012-05-04 |