Advisory Committee Feedback Form

NATIONAL ADVISORY
COMMITTEE FEEDBACK

OMB Control Number: 0970-0519
Expiration Date: 10/31/2021

Form

In order to help National Human Trafficking Training and Technical Assistance Center (NHTTAC) better serve the National Advisory
Committee (NAC), we are reaching out to obtain your feedback. We will protect the privacy of your information in accordance with
the Federal Privacy Act, and we will protect the confidentiality of your responses using procedures we have in place, including
reporting all information in aggregate to avoid identifying information. Only members of the NHTTAC Evaluation Team have access
to information that could identify respondents. If you have any questions about this survey or the evaluation, please contact
[email protected].
Please provide the information below to create an anonymous ID:
______
______
______
Birth Month
(insert just the month
for your date of birth,
example: 08 for August)
1.

First letter of first name
(example: S for Sara)

First letter of your middle name
(example: M for Maria)

In the past 12 months, how many NAC meetings have you participated in?
________________________

2.

3.

Please rate the quality of the NAC meeting(s) that you have attended.
1

2

3

4

Poor

Fair

Good

Excellent

Please rate the quality of the NAC webinar(s) that you have attended.
1

2

3

4

Poor

Fair

Good

Excellent

Please indicate how well the NAC has achieved the following objectives.

OVERALL OBJECTIVES

Poor

Fair

Good

Excellent

4.

[Insert objective 1].

1

2

3

4

5.

[Insert objective 2].

1

2

3

4

6.

[Insert objective 3].

1

2

3

4

7.

[Insert objective 4].

1

2

3

4

8.

[Insert objective 5].

1

2

3

4

9.

As a result of my involvement in the NAC, I made meaningful connections with other professionals in the field of human
trafficking identification, prevention, and service provision.
1

2

3

4

Strongly
Disagree

Disagree

Agree

Strongly Agree

Paperwork Reduction Act Notice
Under the Paperwork Reduction Act, a person is not required to respond to a collection of information unless it displays a valid OMB control
number. The estimated average time to complete this form is 5 minutes. If you have comments regarding the accuracy of this estimate or
additional suggestions, please write to the NHTTAC Evaluation Team at [email protected] or 9300 Lee Highway, Fairfax, VA 22031.

NATIONAL ADVISORY
COMMITTEE FEEDBACK

OMB Control Number: 0970-0519
Expiration Date: 10/31/2021

Form

10. How would you describe the level of collaboration among NAC members?
1

2

3

4

Very weak

Weak

Strong

Very strong

11. How often would you like to meet in person with NAC members? _____________________

12. How would human trafficking service provision be impacted if the NAC did not exist?

____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
13. Looking ahead, what additional activities can the NAC undertake to further collaboration and information sharing that would
be useful to members?

____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Please indicate the extent to which you agree or disagree with the following statements about NHTTAC’s contribution to the
NAC:
Strongly
Disagree

Disagree

Agree

Strongly
Agree

Not
Applicable

14. NHTTAC has been helpful in orienting new
members to the NAC.

1

2

3

4

NA

15. There has been good communication between
NHTTAC and the NAC.

1

2

3

4

NA

16. The information NHTTAC has shared with the
public reflects a public health approach to
addressing human trafficking.

1

2

3

4

NA

17. NHTTAC has been supportive in meeting
planning.

1

2

3

4

NA

18. NHTTAC has been helpful through their onsite
meeting support.

1

2

3

4

NA

19. Based on your interactions with NHTTAC on the NAC, would you recommend NHTTAC to others to receive T/TA?
□ Yes

□ No

Paperwork Reduction Act Notice
Under the Paperwork Reduction Act, a person is not required to respond to a collection of information unless it displays a valid OMB control
number. The estimated average time to complete this form is 5 minutes. If you have comments regarding the accuracy of this estimate or
additional suggestions, please write to the NHTTAC Evaluation Team at [email protected] or 9300 Lee Highway, Fairfax, VA 22031.

NATIONAL ADVISORY
COMMITTEE FEEDBACK

OMB Control Number: 0970-0519
Expiration Date: 10/31/2021

Form

20. What do you think are the most important activities that the NAC should prioritize?

____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
21. Please provide any comments or suggestions on how the NAC can be improved.

____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
22. Is your agency responsible for working with people who are currently being trafficked or have been trafficked?
□ No

□ Yes

23. In your professional capacity, how frequently do you come into contact with a person who is currently being trafficked, at
risk of being trafficked, or has been trafficked?
1

2

3

4

Never

Occasionally

Frequently

All the Time

Thank you for taking the time to complete this form and helping to improve NHTTAC activities.

Paperwork Reduction Act Notice
Under the Paperwork Reduction Act, a person is not required to respond to a collection of information unless it displays a valid OMB control
number. The estimated average time to complete this form is 5 minutes. If you have comments regarding the accuracy of this estimate or
additional suggestions, please write to the NHTTAC Evaluation Team at [email protected] or 9300 Lee Highway, Fairfax, VA 22031.