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Maternal, Infant, and Early Childhood Home Visiting Program All Grantee Meeting Feedback Forms
ICR 202012-0915-001 · OMB 0915-0212 · Object 106785401.
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| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
|---|---|
| File Title | Maternal, Infant, and Early Childhood Home Visiting Program All Grantee Meeting Feedback Forms |
| Author | Rashelle Lee |
| Last Modified By | Writer |
| File Modified | 2018-12-03 |
| File Created | 2026-07-14 |
| Conversion State | complete |
Extracted Text
2019 MIECHV All Grantee Meeting - Individual Session Feedback Form
February 26 – 28, 2019
Public Burden Statement: 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 control number for this project is 0915-0212. Public reporting burden for this collection of information is estimated to average .03 hours per response, including the time for reviewing instructions, searching existing data sources, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to HRSA Reports Clearance Officer, 5600 Fishers Lane, Room 18N136B, Rockville, Maryland, 20857.
Please select your affiliation
☐ MIECHV State Region or Territory
☐ Tribal Home Visiting Program
☐ Other
Please select the role that most closely aligns with your responsibilities related to the MIECHV project.
Grantee Lead/Director/Coordinator
Grantee Data/Evaluation Staff
Grantee Program Staff/Consultant
Grantee Grants Management/Fiscal Staff
Home Visitor
ECCS Coordinator/Staff
Federal Staff/Partner
Model Developer
National TA Provider
Speaker
Other
Please rate each session using the scale listed below
Not at all
Somewhat
Very much
Very little
Quite a bit
Please indicate the degree (enter rating 1, 2, 3, 4 or 5 in the box) to which the Plenary or Breakout session...
Achieved intended objectives
Met your needs
Provided new information
Allotted time for questions and and/or quality discussion
Was well organized, engaging and effectively presented
Speaker(s) demonstrated topic expertise
Provided information you can apply to practice and/or enhanced your professional expertise
Plenary: Date, title and presenter
Breakout Session: Date, title & presenter
What is one thing that you like best about the session:
What is one thing that you would change:
Other comments: