Organizational Scholarship Feedback Form

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

ORGANIZATIONAL
SCHOLARSHIP FEEDBACK
Form

In order to help the National Human Trafficking Training and Technical Assistance Center (NHTTAC) better serve the field, 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
First letter of first name
(insert just the month
(example: S for Sara)
for your date of birth,
example: 08 for August)

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

Part I: NHTTAC Scholarship Program
1.

How did you hear about this NHTTAC Scholarship Program? (Mark all that apply.)
□
□
□
□

NHTTAC Website
Exhibit or presentation at a conference
NHTTAC listserv
OTIP program monitor or other OTIP staff person

□
□
□
□

Another organization
A colleague or friend
A publication or newsletter
Other (please specify): __________________________

2.

What month and year did you apply? ________________________

3.

Would you recommend the NHTTAC Organizational Scholarship to others?

□ Yes

□ No

Please indicate the extent to which you agree or disagree with the following statements.

APPLICATION PROCESS

Strongly
Disagree

Disagree

Agree

Strongly
Agree

Not
Applicable

4.

NHTTAC was responsive to my questions and needs.

1

2

3

4

NA

5.

The application was easy to complete.

1

2

3

4

NA

6.

The application instructions clearly explained the
eligibility requirements.

1

2

3

4

NA

7.

The application instructions clearly explained the expenses
covered under the program.

1

2

3

4

NA

8.

I am satisfied with the notification process.

1

2

3

4

NA

9.

I am satisfied with the overall application process by
NHTTAC.

1

2

3

4

NA

10. What could be done differently to improve the application process?

____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________

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 10 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.

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

ORGANIZATIONAL
SCHOLARSHIP FEEDBACK
Form

11. Do you have any other comments or suggestions?

____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Part II: Event Feedback

12. Please provide the following information about the event you were awarded funds to attend:
Event title: ___________________________________________________________________________________________
Date(s): ______________________________

Location: ____________________________________________________

Event Description: ____________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
Please indicate the extent to which you agree or disagree with the following statements.
Strongly
Disagree

Disagree

Agree

Strongly
Agree

Not
Applicable

13. The event increased my knowledge related to the topic(s).

1

2

3

4

NA

14. The information presented in the event was grounded in
current evidence-based research or promising practices.

1

2

3

4

NA

15. The information presented in the event was traumainformed.

1

2

3

4

NA

16. The information presented in the event was survivorinformed.

1

2

3

4

NA

17. The information presented in the event was grounded in a
multidisciplinary approach to addressing human
trafficking.

1

2

3

4

NA

18. The information provided in the event reflected a public
health approach to addressing human trafficking.

1

2

3

4

NA

19. The event improved my ability to serve people who are
currently being trafficked, at risk of trafficking, or have
been trafficked.

1

2

3

4

NA

20. The education materials provided for this event were
useful.

1

2

3

4

NA

21. The event increased my practical skills related to the
topic(s).

1

2

3

4

NA

22. The event met my professional needs.

1

2

3

4

NA

23. The event met my educational needs.

1

2

3

4

NA

24. I will be able to apply what I learned in my work.

1

2

3

4

NA

EVENT FEEDBACK

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 10 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.

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

ORGANIZATIONAL
SCHOLARSHIP FEEDBACK
Form

25. Please rate the overall quality of this scholarship program.
1

2

3

4

Poor

Fair

Good

Excellent

26. As a result of participating in this scholarship program, do you plan to do any of the following? (Mark all that apply.)

□
□
□
□
□
□
□
□
□
□

Change my management/leadership or
interpersonal communication style
Further develop skills and knowledge about serving
people who are currently being trafficked, at risk of
trafficking, or have been trafficked
Write grants/fundraise/identify new funding
resources
Advocate or meet with leadership of my
organization to develop/enhance vision, mission, or
strategic plan
Advocate or meet with leadership of my
organization to develop/enact policy changes at my
organization
Improve programs/practices
Improve technology/websites/infrastructure
Integrate victim-centered, survivor-informed
strategies
Expand services or types of services
Begin a new project or initiative

□
□
□
□
□
□

□
□
□
□
□
□

Develop/strengthen collaborative or strategic
relationships
Network with other participants
Share materials with colleagues
Provide information to clients/families/youth
Train/educate others in content/skills learned
Raise public awareness/advocacy/outreach
activities offered to people who are currently being
trafficked, at risk of trafficking, or have been
trafficked
Refer colleagues to NHTTAC events/resources
Conduct research
Strengthen evaluation or needs assessment
activities
Improve identification and reporting methods for
trafficking
Take additional training on human trafficking
Other (please specify): __________________

27. Of the barriers listed below, which do you believe will be a significant challenge to performing the activities you selected in
the previous question? (Mark all that apply.)

□
□
□
□
□
□
□
□
□

Lack of senior leadership support
Lack of frontline support and accountability
Continuous turnover
Shortages of key personnel
Competing priorities
Inaccessible research and/or information
Lack of urgency
Lack of shared responsibility across organizational
collaboration
Difficulty in establishing and/or maintaining a
multi-disciplinary team

□
□
□
□
□
□

Need for partnership building with other
organizations
Variation in mission and regulatory frameworks
when partnering with other organizations
Lack of information and/or data sharing among
organizations
Lack of time to implement changes
Lack of training for staff in how to implement
change
Other (please explain): _________________

28. Is your organization responsible for working with people who are currently being trafficked or have been trafficked?
□ Yes

□ No

29. Which of the following best describes the organization in which you work? (Mark all that apply.)

□
□
□
□

Academic institution
Anti-trafficking organization
Business/For-profit organization
Coalition/Multidisciplinary team/Task force

□
□
□
□

Federal government
Faith-based organization
State and local government
Nonprofit/Community-based organization

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 10 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.

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

ORGANIZATIONAL
SCHOLARSHIP FEEDBACK
Form
□
□
□
□

□
□
□

OTIP grantee
Self-employed
Survivor-led organization
Tribal government

Union/Worker advocacy organization
Victim service provider
Other, please specify: _____________________

30. Which of the following best describes your professional capacity or types of services you provide? (Mark all that
apply.)
□ Behavioral health professional (e.g., psychologist,
□ Legal (e.g., immigration, civil and/or rights-based
psychiatrist, mental health/substance use counselor)
attorney and/or paralegal, clinic)
□ Child welfare (e.g., state agency staff, child welfare
□ Public health (e.g., licensure board, health
contractor, nonprofit personnel)
department staff, health care executive, community
□ Corrections-based services (e.g., parole, probation)
health workers)
□ Criminal justice (e.g., law enforcement, prosecutor,
□ Social worker (e.g., case manager, school
probation, court, forensic interviewer)
counselor, supervisor, administrator)
□ Educator (e.g., teacher, professor, school
□ Survivor empowerment, mentoring, or peer to peer
administrator)
□ Violence prevention (e.g., Child abuse and neglect;
□ Health care (e.g., physician, physician assistant,
elder abuse; domestic violence, sexual violence,
nurse practitioner, dentist, nurse, pharmacist)
youth violence)
□ Housing (e.g., case worker, shelter director, public
□ Other (please specify):
_______________________________
housing authority agencies)
31. Which of the following best describes the number of years of experience you have in your current field of work? (Mark one.)
□ Less than 3 years

□ 3 to 5 years

□ 6 to 10 years

□ More than 10 years

32. Which of the following best describes your primary role in your current position?
□ Direct Delivery/frontline staff
□ Consultant/Trainer
□ Management
□ Volunteer
□ Other (please specify): _______________

□ Administration
□ Peer Educator

33. In your professional capacity, how frequently do you come into contact with people who are currently being trafficked, at risk
of being trafficked, or have been trafficked?
1

2

3

4

Never

Rarely

Frequently

All the Time

34. Which of the following best describes your geographic population? (Mark all that apply.)
□
□
□
□

National
State (please specify): ______________
Tribal
International (please specify country):
_________________________________

□

Local
□ Urban
□ Rural
□ Suburban

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 10 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.

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

ORGANIZATIONAL
SCHOLARSHIP FEEDBACK
Form

35. Please select any of the following populations you currently work with in a professional capacity (Mark all that apply.)

□

□

□
□
□
□

Human trafficking
□ Commercial sexual exploitation of
children
□ Sex trafficking
□ Adults
□ Minors
□ Labor trafficking
 Adults
 Minors
Children/youth
□ Out of home/Foster care/Kinship care
□ Juvenile justice
□ Runaway/Homeless youth
People with disabilities
Deaf/Hearing impaired
Elderly
Lesbian, gay, bisexual, transgender, and
questioning

□
□
□

□
□
□
□
□

Foreign nationals (migrant workers, undocumented
immigrants, refugees)
People with low incomes
Racial and ethnic minorities
□ American Indian or Alaska Native
□ Asian
□ Black or African American
□ Native Hawaii or other Pacific Islander
□ White
□ Hispanic or Latino ethnicity
History of substance use
Domestic and dating violence
Gang-related crime
Sexual abuse/Violence
Other (Please specify): __________________

36. What is your race? (Mark all that apply.)

□
□
□
□
□
□

American Indian or Alaska Native
Asian
Black or African American
Native Hawaii or other Pacific Islander
White
Other (please specify): _______________________________________

37. What is your ethnicity? (Mark all that apply.)

□
□
□

Hispanic or Latino
Middle Eastern or North African
Other (please specify): ________________________________________

38. What is your gender? (Mark all that apply.)

□
□
□
□

Male
Female
Transgender
Other (please specify): ________________________________________

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 10 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.