Webinar Participant Survey Form

Form Approved OMB 3014-011 (Expiration Date: 1/31/2018)
Paperwork Reduction Act Notice: The estimated time burden for this webinar
participant feedback survey is 6 minutes. Federal agencies and their contractors may
not conduct or sponsor, and a person is not required to respond to, a collection of
information unless it displays a valid OMB Control Number. Send comments
regarding this burden estimate or any other aspect of this survey instrument to: PRA
Clearance Officer, Office of General Counsel, US Access Board, 1331 F. St., NW, Suite
1000, Washington, DC, 20004.

AccessibilityOnline- [Webinar Title]

* 1. Overall, how satisfied are you with your experience in this webinar?
Very Satisfied
Satisfied
Neither Satisfied or Dissatisfied
Dissatisfied
Very Dissatisfied
Please explain the reason for your overall satisfaction rating:Other (please specify)

AccessibilityOnline- [Webinar Title]

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* 2. I learned about this session from:
Email Announcement
My Regional ADA Center
U.S. Access Board Website
Access Currents
Great Lakes Chronicle
Other
Please let us know where you learned about the webinar, if you answered "other".

AccessibilityOnline- [Webinar Title]

* 3. How was your experience with the Technology for this session?
Good
Fair
Poor
If you responded "Fair" or "Poor" please provide us with additional information about any problems that you experienced.

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AccessibilityOnline- Accessible Court Houses (A refresher)

* 4. What technologies did you use during this session:
Webinar Platform for both audio and visual (via PC)
Webinar Platform for visual and Telephone for audio (via PC)
Mobile App (Iphone, Ipad, Kindle Fire HD or Android Device)
Telephone Only

AccessibilityOnline- [Webinar Title]

* 5. Below you will find a list of possible reasons that a person might have enrolled in this course. Please
read them and then rank them in order of their importance to you, with #1 being of highest importance.
I was interested in the topic.

I need the continuing education credit.

To prevent potential law suits.

My employer / professional organization required me to take the course.

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6. Please add an additional reason you enrolled for the course here, or type in a more detailed description
of your reason for enrolling, if you wish.

AccessibilityOnline- [Webinar Title]

* 7. Please rate your level of satisfaction with these specific aspects of your educational experience with the
presenter: [Presenter Name, Organization]
Very Satisfied

Satisfied

Neither Satisfied
nor Dissatisfied

Dissatisfied

Very Dissatisfied

N/A

Knowledge of the
presenter on the topic
Presentation
organization
Scope or breadth of
information presented
The way the speaker
stuck to the topic
The usefulness of the
material presented

Are there additional comments you would like to make regarding this presenter?

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AccessibilityOnline- [Webinar Title]

* 8. My questions were answered to my satisfaction:
Yes
No
If No, Please Explain:

AccessibilityOnline- [Webinar Title]

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* 9. I will make changes in the way that I perform my work based upon the information presented to me in this session:
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
N/A
Specifically, one change I will make in the way that I do my work is:

AccessibilityOnline- [Webinar Title]

* 10. I will seek additional information on this topic because I participated in this program:
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
N/A

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AccessibilityOnline- [Webinar Title]

* 11. If tomorrow a co-worker asked you what you learned in this session, what one or two points would you
share?

AccessibilityOnline- [Webinar Title]

12. What other related topics would you be interested in learning more about?

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AccessibilityOnline- [Webinar Title]

13. Is there anything that we can do to improve this program or your experience with the AccessibilityOnline
Webinar Series?

AccessibilityOnline- [Webinar Title]

14. If you would like to be added to the list serv to receive announcements regarding the AccessibilityOnline
Program please provide your contact information:
Email Address:

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AccessibilityOnline- [Webinar Title]

THANK YOU for taking our survey. Your response is very important to us. All sessions are recorded and available for viewing within 2
business days following the close of the session. You can access the recording of this session and previous sessions at:
http://www.accessibilityOnline.org

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