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OMB# 1121-XXXX
Date
of Expiration: XXXX
User Feedback
In order to help OVC TTAC better serve the field, we are reaching out to you to obtain your feedback on OVC TTAC materials. 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 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 users, presenters, OVC staff, OVC TTAC staff, and your employer will not have access to what you as an individual say. This survey is voluntary. If you have any questions about this survey or the evaluation, please contact [email protected]. Please complete this survey after you have used the materials.
MATERIALS: pre-printed information
DATE DOWNLOADED/RECEIVED: pre-printed formation
Which of the following best describes the reason you obtained these materials? (Mark one.)
Personal use/assist a family member/friend
For use in undergraduate coursework
For use in graduate coursework
To train colleagues/faculty/victim service providers
To provide services to victims/perpetrators of crime
For use in program development/operations
Other (please specify): __________________________
Approximately how many times have you used this resource?
I have not used it yet
1 time
2-3 times
4-6 times
7+ times
If you used these materials to train/teach others, how many people participated in the training/class? _________________
Please indicate the extent to which you agree or disagree with the following statements.
COMPONENT 1 _______________________________ |
Strongly Disagree |
Disagree |
Neither Agree nor Disagree |
Agree |
Strongly Agree |
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Do you plan to do any of the following as a result of using these materials? (Mark all that apply.)
Educate others in victim issues (i.e., students, victim service providers, perpetrators of crime)
Share materials with colleagues
Refer colleagues to other OVC TTAC events/ resources
Train colleagues in content/skills learned
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 organizations
Identify/pursue new funding resources
Other(s): _____________________________________
Please explain: ________________________________________________________________________________________
Would you recommend OVC TTAC to others? □ Yes □ No
What aspects of the materials were most helpful and why?
____________________________________________________________________________________________________________________________________________________________________________________________________________________
In what ways could the materials have been improved?
____________________________________________________________________________________________________________________________________________________________________________________________________________________
Is there additional information that should be included in the product/publication to make it more accurate and complete? If so, please explain below.
____________________________________________________________________________________________________________________________________________________________________________________________________________________
What modifications should be made to the product/publication (if any) to improve it and make it more relevant to your work and other individuals who work with you on this topic(s)?
____________________________________________________________________________________________________________________________________________________________________________________________________________________
Do you have any other comments or suggestions?
____________________________________________________________________________________________________________________________________________________________________________________________________________________
Are there any resources you would suggest we link to from the materials? If so, please provide the link if hosted online and provide a description below. If they are not hosted online, please email us a copy at [email protected]
____________________________________________________________________________________________________________________________________________________________________________________________________________________
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): __________________________
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): __________________________
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
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): _________________________
Which of the following best describes the population you serve? (Mark all that apply.)
I do not provide direct services
National
State
Tribal
International, list country: _________________
Local
Urban
Rural
Suburban
Culturally specific population(s):__________________
What is your zip code: __________________
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.
File Type | application/msword |
File Title | OVC TTAC - USER FEEDBACK FORM |
Author | goellen |
Last Modified By | Scarborough, Angela |
File Modified | 2015-01-07 |
File Created | 2015-01-07 |