Professional Development Scholarship Feedback Form

NHTTAC Consultant and Evaluation Package

9 - Prof Dev Scholarship Feedback

Professional Development Scholarship Feedback Form

OMB: 0970-0519

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0970-0519 can be found here:

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

PROFESSIONAL DEVELOPMENT
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 Scholarship Program? (Mark all that apply.)
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□
□

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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): __________________________

What month and year did you apply? ________________________

Would you recommend the NHTTAC Professional Development Scholarship to others?

□

□ No

Yes

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

APPLICATION PROCESS

Strongly
Disagree

Disagree

Agree

Strongly
Agree

Not
Applicable

NHTTAC was responsive to my questions and needs.

The application was easy to complete.

The application instructions clearly explained the
eligibility requirements.

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

I am satisfied with the notification process.

I am satisfied with the overall application process by
NHTTAC.

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

PROFESSIONAL DEVELOPMENT
SCHOLARSHIP FEEDBACK

Form

11. Do you have any other comments or suggestions about the application process?

____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Please rate the following registration, pre-meeting service, and logistical arrangements using the following scale:
Poor

Fair

Good

Excellent

Not
Applicable

12. Meeting registration

13. Onsite registration check-in process

14. Attendee meeting packet

15. Meeting direction signs

16. Conference meeting room

17. Travel information (if applicable)

18. Hotel accommodations (if applicable)

LOGISTICS

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

Poor

Fair

Good

Excellent

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

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□
□
□
□
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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

□
□
□
□
□
□
□

OTIP grantee
Self-employed
Survivor-led organization
Tribal government
Union/Worker advocacy organization
Victim service provider
Other, please specify: _____________________

21. 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,
□ Health care (e.g., physician, physician assistant,
psychiatrist, mental health/substance use counselor)
nurse practitioner, dentist, nurse, pharmacist)
□ Child welfare (e.g., state agency staff, child welfare
□ Housing (e.g., case worker, shelter director, public
contractor, nonprofit personnel)
housing authority agencies)
□ Corrections-based services (e.g., parole, probation)
□ Legal (e.g., immigration, civil and/or rights-based
□ Criminal justice (e.g., law enforcement, prosecutor,
attorney and/or paralegal, clinic)
probation, court, forensic interviewer)
□ Public health (e.g., licensure board, health
□ Educator (e.g., teacher, professor, school
department staff, health care executive, community
administrator)
health workers)
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

PROFESSIONAL DEVELOPMENT
SCHOLARSHIP FEEDBACK

Form
□

□

Social worker (e.g., case manager, school
counselor, supervisor, administrator)
Survivor empowerment, mentoring, or peer to peer

□

Violence prevention (e.g., Child abuse and neglect;
elder abuse; domestic violence, sexual violence,
youth violence)
Other (please specify):
_______________________________

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

□ No

23. 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

24. 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

25. 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

Never

Rarely

Frequently

All the Time

26. 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

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

□

□
□
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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

□
□
□
□

□
□
□
□
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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): __________________

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

PROFESSIONAL DEVELOPMENT
SCHOLARSHIP FEEDBACK

Form

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

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

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

□
□
□

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

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

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□
□
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Male
Female
Transgender
Other (please specify): ________________________________________

Part II. Event Feedback
31. Please provide the following information about the event you attended with scholarships funds:
Event title: ___________________________________________________________________________________________
Date(s): ______________________________

Location: ____________________________________________________

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

EVENT FEEDBACK

Strongly
Disagree

Disagree

Agree

Strongly
Agree

Not
Applicable

32. The event increased my skills and knowledge related to the
topic(s).

33. The event improved my knowledge of current evidencebased research or promising practices.

34. The event improved my skills and knowledge about traumainformed practices.

35. The event improved my skills and knowledge about
survivor-informed practices.

36. The event improved my skills and knowledge about a
multidisciplinary approach to addressing human trafficking.

37. The event improved my skills and knowledge about a public
health approach to addressing human trafficking.

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

PROFESSIONAL DEVELOPMENT
SCHOLARSHIP FEEDBACK

Form

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

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

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

41. The event met my professional needs.

42. The event met my educational needs.

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

44. At which type of event was the training held?
□ National conference
□ State/regional conference

□ Local conference
□ Other (please specify): __________________________

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

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□
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□
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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

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□
□
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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): __________________

46. 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.)

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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

□
□
□
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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

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

PROFESSIONAL DEVELOPMENT
SCHOLARSHIP FEEDBACK

Form
□

Lack of training for staff in how to implement
change

□

Other (please explain): _________________

47. What aspects of the event were most helpful and why?

____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
48. Do you have any other comments or suggestions about the event?

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

File Type	application/pdf
Author	Field, Michael
File Modified	2019-11-01
File Created	2019-11-01