Form FEMA Form 078-0-2A FEMA Form 078-0-2A NFA Long Term Evaluation Students/Trainees

National Fire Academy Long‐Term Evaluation Form

O.M.B. No. 1660-0039 (Expires XXXX)

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FEMA Form 078-0-2A (MMM YY, Students)

Paperwork Reduction Act Notice | OMB No. 1660-0130

Paperwork Reduction Act Notice
Public reporting burden for this form is estimated to be an average of 10 minutes per response. The burden includes the time for reviewing instructions, searching existing data sources,
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valid OMB control number appears in the upper right corner of this form. Send comments regarding the accuracy of the burden estimate and any suggestions for reducing the burden to:
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(1660-0032) NOTE: Please do not send your completed form to the above address.

U.S. Fire Administration, 16825 S. Seton Ave., Emmitsburg, MD 21727 | USNG: 18SUJ00529652
(301) 447-1000

Fax: (301) 447-1346

Admissions Fax: (301) 447-1441

National Fire Academy Long‐Term Evaluation Form for Students
(FEMA Form 078‐0‐2A)
Completion Instructions
1.

Begin by verifying the course dates and title below to make sure this is your course.

2.

Use the buttons at the bottom of each page to navigate through the form.

3.

DO NOT enter your name in any location on the form so that your evaluation may remain anonymous.

4.

At any time you may click the Save and Finish Later button to save your form and return to it later.

Course Title:

Executive Development

Course Code:

R0123

Course Dates:

9/23/2013 - 10/4/2013

Long-Term Student Evaluation

The Save and Finish Later button will allow you to save answers already provided and come back to the form at a later time to complete it (provided the evaluation period hasn't expired).
FEMA Form 078-0-2A (MMM YY)

U.S. Fire Administration, 16825 S. Seton Ave., Emmitsburg, MD 21727 | USNG: 18SUJ00529652
(301) 447-1000
Fax: (301) 447-1346
Admissions Fax: (301) 447-1441

Paperwork Reduction Act Notice | OMB No. 1660-0130

National Fire Academy Long‐Term Evaluation Form for Students
(FEMA Form 078‐0‐2A)
Student Evaluation
Why did you take this course? (Mark all that apply.)
Supervisor recommended it
Attendance was required for my next duty or assignment
For general career advancement
Desire to broaden my perspective by working with personnel from across the country
Desire to increase my technical and professional knowledge
Other (please specify)

Did you check whether the course was from a source other than the National Fire Academy?
Yes
No (Skip to the next question)

Where else was it available?
At a facility in my state
At a facility in this region but not in my state
Other (please specify)

What is the highest level of education you have achieved?
Less than high school graduation

Bachelor's Degree

High school graduation or equivalency

Graduate degree

Some college

Other (please specify)

Associate's degree

Now indicate your level of agreement or disagreement with each statement by selecting the appropriate value.
Strongly Agree

Agree

Neutral

Disagree

Strongly
Disagree

Not Applicable

What I learned from this course helped me do my job better.
This course has contributed to my professional development.
My supervisor is aware of how this course has improved my job performance.
This training has helped the department address all hazard problems in our community's high risk areas.
This NFA training has led to risk reductions in the community.
This NFA training has improved the performance of my department.
Since my NFA course, I have continued to collaborate and/or network with other NFA students.

Have you used any of the training or information from this course on the job since returning to your department?
Yes
No

To what extent have you used information from the topics covered in your training?
Used a Great Deal
Use of both authoritarian and non-authoritarian models of leadership.
Addressing technical as well as adaptive problems.
Applying feedback from multi-rating psychological assessment tests.
Use of consensus building and teamwork in resolving conflicts.
Engaging in change management.
Completion or continued work on applied research project.

Used Somewhat

Not Used at All

No Opportunity to Use

Participation in a research practicum.
Identifying elements of organizational culture needing change.
Addressing ethical issues tied to organizational change.
Completion of personal research proposal form.
Stressing high quality service.
Preparation and/or review of review research proposals.

Did you leave this training expecting to develop new policies or procedures for your department?
Yes
No

Did you actually develop them?

Were these policies or procedures implemented?

Yes

Yes

No

No

Have you shared the information you learned at the training with colleagues in the department?
Yes
No

How did you do it? (Mark all that apply.)
Informally, one-on-one
Informally, but in a group setting
Formally in a training session
Other (please specify)

Would you recommend this course to others in your department?
Definitely yes
Probably
Unsure
Probably not
Definitely not

If you could change one thing to improve this training course, what would it be?

Do you see any emerging issues in the fire/emergency sevices field that are not currently covered by NFA courses?

What skills do you, your co-workers and supervisors need that training would improve?

Additional comments?

The Save and Finish Later button will allow you to save answers already provided and come back to the form at a later time to complete it (provided the evaluation period hasn't expired).

FEMA Form 078-0-2A (MMM YY)

Paperwork Reduction Act Notice | OMB No. 1660-0130

U.S. Fire Administration, 16825 S. Seton Ave., Emmitsburg, MD 21727 | USNG: 18SUJ00529652
(301) 447-1000

Fax: (301) 447-1346

Admissions Fax: (301) 447-1441