Money Smart for Older Adults Train-the-Trainer Session Feedback Form and Money Smart for Older Adults Participant Evaluation Form

Generic Information Collection Plan for the Collection of Qualitative Feedback on Bureau Service Delivery

Trainer Survey_20151209

Money Smart for Older Adults Train-the-Trainer Session Feedback Form and Money Smart for Older Adults Participant Evaluation Form

OMB: 3170-0024

Document [pdf]
Download: pdf | pdf
Session Feedback Form
Money Smart for Older Adults Train-the-Trainer
About this training:
Training location:_____________________
Training date:________________________
Trainer (s):__________________________

City: ________________________
State:________________________
Number of participants:__________

Thank you for participating in the Money Smart for Older Adults Train-the-Trainer session. To
help us improve future sessions, please complete this form.
1)

How was the
training conducted?

In-person
presentation

Webinar

Small
discussion
session

Other

2)

The information
presented today
was clear and easy
to understand.

Strongly
disagree

Disagree

Neutral

Agree

Strongly
Agree

3)

The length of the
session was:

Too short

Just right

Too long

4)

The handouts were
useful.

Strongly
disagree

Disagree

Neutral

Agree

Strongly
Agree

5)

Did you experience
any technical
difficulties?

Yes

No

N/A

Disagree

Neutral

Agree

Strongly
Agree

If yes, briefly explain:

6)

I feel comfortable
teaching Money
Smart for Older
Adults after today.

Strongly
disagree

If disagree or strongly disagree, why not?

OMB No. 3170-0024, expiration date 11/30/2018

7)

I would recommend
this Money Smart
for Older Adults
train-the-trainer
session to my
peers.

Strongly
disagree

Disagree

Neutral

Agree

Strongly
Agree

Agree

Strongly
Agree

If disagree or strongly disagree, why not?

8)

9)

I am likely to train
clients using the
Money Smart for
Older Adults
curriculum.

Strongly
disagree

Disagree

Neutral

Other comments or
suggestions (use
reverse side if you
need more space):

Privacy Act Statement
5 U.S.C. 552(a)(e)(3)
The information you provide to the Consumer Financial Protection Bureau (“CFPB”), will only be used to evaluate the Money
Smart for Older Americans Train the Trainer Sessions. Information collected will be treated in accordance with the System of
Records Notice (“SORN”), CFPB.021 – CFPB Consumer Education and Engagement Records, 77 F.R. 60382. This information
will only be disclosed as outlined in the Routine Uses for the SORN. Direct identifying information will only be used to facilitate
the evaluation of the training and will be kept private except as required by law. This collection of information is authorized by
Pub. L. No. 111-203, Title X, Sections 1013 and 1022, codified at 12 U.S.C. §§ 5493 and 5512. Participation in this evaluation is
voluntary, you are not required to participate or share any identifying information and you may withdraw participation at any time.
However, if you do not include the requested information, you may not be able to participate in the evaluation.
Paperwork Reduction Act
According to the Paperwork Reduction Act of 1995, an agency 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. The OMB control number for this collection
is 3170-0024. The time required to complete this information collection is estimated to average approximately 5 minutes per
response. Comments regarding this collection of information, including the estimated response time, suggestions for improving
the usefulness of the information, or suggestions for reducing the burden to respond to this collection should be submitted to
Bureau at the Consumer Financial Protection Bureau (Attention: PRA Office), 1700 G Street NW, Washington, DC 20552, or by
email to [email protected].

OMB No. 3170-0024, expiration date 11/30/2018


File Typeapplication/pdf
File TitleMoney Smart Orientation
AuthorSachie Tanaka
File Modified2015-12-09
File Created2015-12-09

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