OMB # 1121-0277
Date of Expiration: xx/xx/xxxx
<Insert Conference Title>
OVERALL CONFERENCE FEEDBACK FORM
Thank you for attending the <insert conference title> supported by the Office of Juvenile Justice and Delinquency Prevention (OJJDP) National Training and Technical Assistance Center (NTTAC). To better serve you, we would like to know how satisfied you were with the quality of the conference. Your feedback is indispensable in our ongoing efforts to improve the support that OJJDP provides. Your participation is completely voluntary.
For Questions 1–13, please indicate the extent to which you agree or disagree with the following statements about the conference.
1 – I Strongly Disagree with this statement (SD).
2 – I Disagree with this statement (D).
3 – I Neither agree nor disagree with this statement (N).
4 – I Agree with this statement (A).
5 – I Strongly Agree with this statement (SA).
NA – Not Applicable (NA).
OVERALL CONFERENCE FEEDBACK |
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What aspects of the conference were most helpful and why?
What aspects of this conference would you suggest changing to make it better for future participants?
As a result of your attendance at the conference, please indicate any additional training and/or technical assistance needs that would be helpful to you/your organization in doing your work?
Please indicate the session topics that should be addressed in the next conference and the level of information that should be provided.
Session Topic Suggestions |
Level of Information Needed |
||
1) |
Beginner |
Intermediate |
Advanced/ Expert |
2) |
Beginner |
Intermediate |
Advanced/ Expert |
3) |
Beginner |
Intermediate |
Advanced/ Expert |
Which of the following best describes the field in which you work? (Please choose only one.)
Ancillary youth services (e.g., recreation, prevention, mentoring, after-school)
Child and family services (e.g., child welfare, adoption)
Community-based organization
Compliance monitors
Corrections
Detention
Court services
DMC coordinator
Education/schools
Faith-based organization
Information technology
Juvenile justice specialist
Law enforcement
Legal services–defense
Legal services–prosecution
Mental health
Other advocacy (e.g., GAL, CASA)
Other residential services
Parole/community corrections
Private sector/business
Probation
Problem solving/specialized courts (e.g., drug courts)
Research
SAG representative
Substance abuse
Truant youth/dropout
Youth mentoring
How many years of experience do you have in the field of juvenile justice?
0 – 2 years
3 – 5 years
6 – 8 years
9 – 11 years
12 – 14 years
15 or more years
How would you describe the population with which you primarily work? (Check all that apply.)
At-risk youth
Children of incarcerated parents
Dependent youth
Incarcerated youth
Homeless youth
Mentally ill youth
Pre-adjudicated youth (e.g., youth awaiting a judicial outcome)
Post-adjudicated youth (e.g., youth on parole, probation, or under community supervision)
Substance using or abusing youth
Teen parents
Youth younger than 10 years of age
Youth ages 11–15 years
Youth ages 16–the legal age of adulthood in your community
Youth in the child welfare system (e.g., foster youth, adopted youth, abused/neglected youth)
Youth volunteers
Other: ______________
We will follow up with a random sample of participants to determine
the impact of this session/event. If you would be willing to
participate in a brief follow-up interview, please provide
your contact information below. The information will only be used
for the purpose of conducting the follow-up interview. The
confidentiality of the information you provide is guaranteed.
Name: _____________________________ Phone:
__________________ E-mail:_____________________
See other side
File Type | application/msword |
File Title | OVC TTAC - USER FEEDBACK FORM |
Author | goellen |
Last Modified By | 15067 |
File Modified | 2011-06-17 |
File Created | 2011-06-17 |