Form 73-043 Field Representative Feedback Form

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

Feedback Form

Student and Exchange Visitor Program (SEVP)/Field Representative (FR) Feedback Form

OMB: 1653-0050

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[Page 1]


Field Representative Feedback Form


Please provide feedback on your most recent meeting with a Field Representative. 

Student and Exchange Visitor Program (SEVP) field representatives serve as liaisons between SEVP and SEVP-certified schools. As a stakeholder resource, the field representatives enhance national security by fostering regulatory adherence and Student and Exchange Visitor Information System (SEVIS) data integrity. [SOURCE]

Please note that all feedback provided through this form is only reviewed by Student and Exchange Visitor Program (SEVP) Field Representative Unit management. Individual SEVP field representatives do not see the information submitted.



* Indicates required question.

Territory*

Field Representative Name*

Date of Meeting*

School/organization Name*

Your Name*

Email Address*


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Subject Matter Expert

  1. Field Representative was knowledgeable on SEVP-related rules and regulations. *

    • Comments

  2. Field Representative was able to direct school towards resources on SEVIS-related reporting requirements, policies/procedures, and training. *

    • Comments

  3. Field Representative was able to facilitate a better understanding of SEVIS functionality. *

    • Comments

[Answer choices] Exceeds Expectations, Meets Expectations, Does Not Meet Expectations, or Not Applicable.



[Page 3]


Professionalism

  1. Field Representative was efficient and professional when scheduling the meeting. *

    • Comments

  2. Field Representative arrived for meeting at or before the scheduled time or communicated regarding any delay. *

    • Comments

  3. Field Representative conducted the meeting professionally. *

    • Comments

[Answer choices] Yes, No, or Not Applicable.


[Page 4]


Additional Feedback


Thank you for providing feedback on your most recent meeting with a Field Representative, which helps with continued improvement of the field representative program. [SOURCE]


Please email [email protected] with any additional comments or feedback.


Please note that all feedback provided through this form is only reviewed by Student and Exchange Visitor Program (SEVP) Field Representative Unit management. Individual SEVP field representatives do not see the information submitted.



File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorPilleux-Petronia, Kelly
File Modified0000-00-00
File Created2023-08-27

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