Employment First State Leadership Mentoring Program (EFSLMP) Community of Practice (CoP) Webinar Feedback Surveys

OMB Control Number: 1225-0088

Expires: xx/xx/20xx

Sample CoP Webinar Feedback Form

1. What was your overall impression of the CoP webinar?

• Poor

• Fair

• Good

• Excellent

2. How relevant was the information in Webinar Presentations to you with respect to the work you are doing to support Employment First systems change efforts in your state/community?

• Not relevant

• Somewhat relevant

• Relevant

• Very relevant

3. How likely is it that you will adopt* the technical assistance provided in today’s webinar? * Adoption: The commitment by an entity to implement an ODEP policy strategy or effective practice.

• Not at all likely

• Somewhat likely

• Likely

• Very likely

4. How likely is it that you will implement* the technical assistance provided in today’s webinar? * Implementation: The effectuation of an ODEP policy strategy or effective practice by an entity or organization.

• Not at all likely

• Somewhat likely

• Likely

• Very likely

5. The length of the webinar was…

• Much shorter than appropriate

• Slightly shorter than appropriate

• Appropriate

• Slightly longer than appropriate

• Much longer than appropriate

6. The webinar was conducted...

• Very ineffectively

• Ineffectively

• Effectively

• Very effectively

7. What suggestions do you have for improving the webinar series for this quarter’s theme?

8. Are there any topic areas that you would like to be addressed in a future SME Insight (blog) or CoP Webinar?

9. Any other comments?

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Burden Statement—The public reporting burden for this collection of information is estimated to average five (5) minutes per response, including the time for reviewing instructions, gathering information, and completing and reviewing the collection of information. Send comments on the Agency’s need for this information, the accuracy of the provided burden estimates, and suggestions for reducing the burden to the U. S. Department of Labor, Office of Disability Employment Policy (EFSLMP), Room S-1303, 200 Constitution Avenue, N.W., Washington, DC 20210. Do not send the completed survey to this address.