OTI Evaluation Form 49 Generic IC

		OMB NO 1225-0088 Exp. Date: 10/31/2020 OSHA Form 49
Course Evaluation Course Title/Number Course Date

Rating

Your feedback is important! Please respond to each statement below and provide additional course and/or instructor comments on the back of this form. Thank You!		1 Strongly Disagree	2 Disagree	3 Neutral	4 Agree	5 Strongly Agree	N/A
1. Course goal/learning objectives were accomplished
Comments
2. Training environment was conducive to learning
Comments
3. Course topics were relevant to my job needs
Comments
4. Practice exercises/workshops/fieldtrips were effective
Comments
5. Instructional staff provided relevant feedback
Comments
6. I would recommend this course to others
Comments

Would you change anything about this course? If yes, please explain.

Feedback for Instructor(s) and/or Developer(s):

[Type here]

PAPERWORK REDUCTION ACT STATEMENT

Under the Paperwork Reduction Act, a Federal agency generally cannot conduct or sponsor, and the public is generally not required to respond to, an information collection, unless it is approved by OMB and displays a valid OMB Control Number.  Public reporting burden for this collection of information is estimated to average 5 minutes.  This estimate includes the time for reviewing instructions, determining goals, and developing objectives for the agreement.  Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to the US Department of Labor-OASAM, Office of the Chief Information Officer Attention: Information Management Program, 200 Constitution Avenue N.W. Room N1301 Washington D.C. 20210 or email [email protected]  and reference the OMB Control Number 1225-0088.