REGISTRATION FORM
Please answer the following:
First Name: ______________ Last Name: ______________
Degree(s) (e.g., B.A., M.S., Ph.D., etc.): _______________
What is your current professional role? (You may select up to 2 roles.)
Federal agency employee based in DC |
State or territory administrator |
Local service organization Foundation staff Other (specify) _____________________ |
Federal agency employee based in a region |
State or territory agency staff member |
|
Researcher |
Local administrator/staff |
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Training or technical assistance provider |
National policy organization staff |
In 1-2 sentences, how would you define ‘cultural responsiveness’?
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What made you decide to register for this event? (Select all that apply.)
Cultural responsiveness is a priority at my office/organization.
I am personally interested in learning more about cultural responsiveness.
A colleague or supervisor encouraged me to participate.
My office/organization has difficulty serving members of minority populations.
Paperwork
Reduction Act Statement: This collection of information is voluntary
and will be used to collect participant feedback. Public reporting
burden for this registration form is estimated to average 5 minutes
per response, including the time for reviewing instructions,
gathering and maintaining the data needed, and reviewing the
collection of information. Public reporting burden for two polls is
estimated to average 5 minutes per response for each poll. 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. The OMB number and expiration
date for this collection are OMB #: 0970-0401, Exp: 05/31/2018. Send
comments regarding this burden estimate or any other aspect of this
collection of information, including suggestions
for reducing this burden to XX.
WEBINAR POLL 1
On a scale of 1 (never) to 5 (constantly), how much does your organization/office struggle with reaching members of minority populations?
1 (never) 2 (occasionally) 3 (regularly) 4 (often) 5 (constantly)
Can you think of an example when your organization/office advanced one of the components of cultural responsiveness that this model identifies? Please share.
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Which components of cultural responsiveness could your organization/office address more effectively? (Select all that apply.) Please explain.
Cultural awareness/knowledge
Skills development
Organizational support
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Paperwork
Reduction Act Statement: This collection of information is voluntary
and will be used to collect participant feedback. Public reporting
burden for this registration form is estimated to average 5 minutes
per response, including the time for reviewing instructions,
gathering and maintaining the data needed, and reviewing the
collection of information. Public reporting burden for two polls is
estimated to average 5 minutes per response for each poll. 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. The OMB number and expiration
date for this collection are OMB #: 0970-0401, Exp: 05/31/2018. Send
comments regarding this burden estimate or any other aspect of this
collection of information, including suggestions
for reducing this burden to XX.
WEBINAR POLL 2
How do these examples demonstrate our understanding of cultural responsiveness as a process? Please explain.
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How can collaboration between offices at ACF encourage cultural responsiveness? Please explain.
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What challenges might you encounter in adopting some of these culturally-responsive processes in your services?
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Please share examples of any successes you’ve had with similar culturally-responsive processes in your services.
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Paperwork
Reduction Act Statement: This collection of information is voluntary
and will be used to collect participant feedback. Public reporting
burden for this registration form is estimated to average 5 minutes
per response, including the time for reviewing instructions,
gathering and maintaining the data needed, and reviewing the
collection of information. Public reporting burden for two polls is
estimated to average 5 minutes per response for each poll. 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. The OMB number and expiration
date for this collection are OMB #: 0970-0401, Exp: 05/31/2018. Send
comments regarding this burden estimate or any other aspect of this
collection of information, including suggestions
for reducing this burden to XX.
ATTENDEE FEEDBACK FORM
In 1-2 sentences, how would you define ‘cultural responsiveness’?
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Please rate the statements using the following scale: 1=Poor, 2=Fair, 3=Good and 4=Excellent.
My overall impression of the meeting was: …
The information discussed and provided was: …
The presenters and moderators were: …
After attending, my understanding of the topic matter is: …
The logistics and accessibility of the meeting were: …
Were the presentations, discussions, and topics covered relevant to your work? Please explain. ______________________________________________________________________________
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What topics would you like to have covered in future meetings? Are there issues that emerged that you would like to see addressed or explored further, e.g., through a webinar, roundtable, conference call, briefing paper, or workgroup? If so, please specify the topics and preferred format.
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Which part of the discussion did you find most effective and why?
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What can we improve for next time in terms of meeting content (e.g., topics, sessions, participants)? Suggestions would be appreciated.
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What can we improve for next time in terms of meeting format? Please explain.
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Are there any ACF initiatives that really exemplify cultural responsiveness that the series ought to highlight?”
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Can you think of any program staff or grantees who weren’t in attendance at the first webinar and whom we should invite to future webinars?
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Do you have anything else that you would like to share?
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Paperwork
Reduction Act Statement: This collection of information is voluntary
and will be used to collect participant feedback. Public reporting
burden for this collection of information is estimated to average 10
minutes per response, including the time for reviewing
instructions, gathering and maintaining the data needed, 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. The OMB number and expiration date for this collection are
OMB #: 0970-0401, Exp: 05/31/2018. Send
comments regarding this burden estimate or any other aspect of this
collection of information, including suggestions
for reducing this burden to XX.
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | Windows User |
File Modified | 0000-00-00 |
File Created | 2021-01-22 |