Form 0920-0974 Customer Satisfaction Survey

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

Att_1_0920-0974_2019 Science Ambassador Training Customer Satisfaction Survey

2019 Science Ambassador Training Customer Satisfaction Survey

OMB: 0920-0974

Document [docx]
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Form Approved
OMB No. 0920-0974
Expiration Date: 10/31/2019



Attachment 1. 2019 Science Ambassador Training Customer Satisfaction Survey



[Page 1: Introduction]

The Centers for Disease Control and Prevention (CDC) Science Ambassador Team is looking for your input on how we can improve access to the Science Ambassador training programs.



You may take this survey anonymously. Information will be treated in a secure manner. This survey should take no more than 5 minutes to complete. We appreciate your input and honest feedback.

If you have any questions or concerns, please reach out to us at [email protected].





























The public reporting burden of this collection of information is estimated to average 5 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to - CDC/ATSDR Reports Clearance Officer; 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333 ATTN: PRA (0920-0974).



[Page 2: General professional development preferences]

For each of the following questions, we would like you to think about your availability and preference for professional development/trainings in general, even if you are not interested in participating in a future Science Ambassador training or fellowship.

  1. In general, which month(s) of the year would be the best time for you to participate in a 2-day professional development or training? Select all that apply.

Best time of year

  • January

  • February

  • March

  • April

  • June

  • July

  • August

  • September

  • October

  • November

  • December



















  1. In general, which month(s) of the year would be the most difficult time for you to participate in a 2-day professional development or training? Select all that apply.

Worst time of year

  • January

  • February

  • March

  • April

  • June

  • July

  • August

  • September

  • October

  • November

  • December




















  1. What days of the week would be the best time for you to participate in a 2-day training?

  • Monday/Tuesday

  • Tuesday/Wednesday

  • Wednesday/Thursday

  • Thursday/Friday

  • Friday/Saturday

  • Saturday/Sunday

  • Sunday/Monday

  • No Preference


  1. What types of incentives are important to you when looking for a professional development opportunity? Select all that apply.

  • Continuing Education Units (CEUs) or equivalent

  • Free, ready-to-go lesson plans or activities

  • Lesson plans or activities, specifically aligned with Next Generation Science Standards

  • The ability to work with scientists

  • Being able to visit facilities like a laboratory or emergency operations center

  • Getting a title like “Fellow” or “Ambassador”

  • Free school supplies

  • Other (please specify ____________)

[Page 3: Science Ambassador Feedback]

  1. From your perspective, what can the Science Ambassador team do to reach more teachers? Select all that apply.

  • Offer a second summer course to accommodate for more Science Ambassador Fellows

  • Offer 2-day in-person trainings at CDC headquarters in Atlanta

  • Offer 2-day regional in-person trainings across the country

  • Offer online workshops

  • Present more at national education conferences like the National Science Teacher Association annual meeting

  • Other (please explain ____________)



  1. Where are you most likely to attend a Science Ambassador training?

  • CDC Headquarters in Atlanta

  • Within 100 miles of my home like at a local college or university

  • No preference

  • Other (please explain ____________)



  1. What is the biggest barrier for attending Science Ambassador training workshops?

  • Funding

  • Support of school

  • Time off

  • Finding a substitute

  • Other professional development opportunities are more interesting

  • Other (please specify ____________)



  1. How can the Science Ambassador program improve its services to teachers (i.e., Science Ambassador Workshop/Fellowship, Science Ambassador regional training workshops)? (Open-ended)

[Page 4: About You]

  1. Were you previously or are you currently a CDC Science Ambassador Fellow?

  • Yes

  • No



  1. Have you attended a CDC Science Ambassador Regional Training Workshop?

  • Yes

  • No



  1. In what country do you live? [Drop down menu]



  1. In what state or U.S. territory do you live? [Drop down menu]



  1. In which type of school do you teach?

  • Charter

  • Public (Skip to Question 14)

  • Private

  • Collegiate

  • Curriculum designer

  • Other educational leadership position

  • No longer a teacher

  • Other (please specify): __________________

Skip to End of Survey

[Page 4: About You: Public Schools]

  1. Do you currently teach at a Title 1 school?

  • Yes

  • No

  • Not sure

[End of Survey] Thank you for completing this survey. We appreciate your input and honest feedback. If you have any questions or concerns, please reach out to us at [email protected].



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File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorMcKenna, Molly (CDC/DDPHSS/CSELS/DSEPD)
File Modified0000-00-00
File Created2021-01-15

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