3170-0067 (2019) Instrument 2 Pre-Training Survey 02-20-19 OMB

OMB Control Number: 3170-0067
Expiration Date: XX/XX/XXXX

Pre-Training Survey for Your Money, Your Goals

For completion by training participants at the beginning of a Your Money, Your Goals training. Return
this survey to your trainer.

Thank you for completing this survey. This information is being collected to help the Consumer Financial
Protection Bureau evaluate the effectiveness of Your Money, Your Goals training. Complete this survey,
providing short written responses and selecting from response options, as prompted by the survey questions.
Please note that your responses will be kept private to the extent permitted by law and when survey results are
reported none of your answers will be directly connected to you. Please see the Privacy Notice and Paperwork
Reduction Act statement on the last page of this survey.
1. What organization are you representing at today’s training?
Organization
City & State
Zip Code
2. What organization is hosting today’s training? This may be your own organization.
Organization
3. What is your email address? Your email address will be used to link the pre- and post-training
surveys you complete together and send you a follow-up survey. When the survey results are
reported, none of your responses will be directly connected to you.
Email address
4. How confident are you in your ability to help other people with the following topics?

a. Budgeting
b. Saving
c. Managing credit and debt
d. Setting goals
e. Asserting their rights when they
have a problem with a financial
product, service, or company

Not at all A little
confident confident

1

Somewhat
confident

Very
Extremely
confident confident

OMB Control Number: 3170-0067
Expiration Date: XX/XX/XXXX

5. Prior to today’s training, have you ever looked at any Your Money, Your Goals materials or the
program’s website?
Yes
No
6. Are you here to learn how to train frontline staff or volunteers to use Your Money, Your Goals
with the people they serve?
Yes
No

Go to question 10

7. In the past year, how many trainings on any topic have you led for frontline staff or volunteers
who work for your organization or others in your community?
None
1-2
3-4
5-10
11 or more
8. In the past year, have you trained frontline staff or volunteers about how to talk about money
with the people they serve?
Yes
No
9. How confident are you in your ability to . . .
a. Train staff members or volunteers
about how to talk about money with
the people they serve?
b. Identify high quality financial
information and resources to share
with staff members and volunteers
you train?
c. Explain why financial management
is important for staff and volunteers
to bring up with the people they
serve?

Not at all
confident

A little Somewhat
Very
Extremely
confident confident confident confident

Page 2

OMB Control Number: 3170-0067
Expiration Date: XX/XX/XXXX

10. Are you here to learn how to use Your Money, Your Goals directly with the people you serve?
Yes
No

You are now finished with the survey.

11. In a typical week, how many people do you serve in the following settings:
a. One-on-one appointments
b. Group workshops or classes

None

1-5

6-15

16-25

26-50

51 or more

12. In the past month, have you discussed or shared materials related to money management
with people in the following settings?
a. One-on-one appointments

Yes

How many?

b. Group workshops or classes

No

Not sure

How many?

13. For each statement below, please indicate how much you agree or disagree.

a. I do not have time to talk about
finances during client interactions.
b. I am comfortable talking about
finances with clients.

Strongly
Neither agree
disagree Disagree nor disagree

Agree

Strongly
agree

14. How confident are you in your ability to . . .

a. Talk about core financial management
topics with the people you serve?
b. Identify high quality financial
information and resources to share
when the people you serve have
questions?
c. Incorporate financial topics into
conversations with the people you
serve?

Not at all A little Somewhat
Very
Extremely
confident confident confident confident confident

15. Today’s date
mm/dd/yyyy
Page 3

OMB Control Number: 3170-0067
Expiration Date: XX/XX/XXXX
Privacy Act Statement
Information you provide in response to this survey will help the survey sponsor, the Consumer Financial Protection
Bureau (Bureau), evaluate the effectiveness of Your Money, Your Goals training.
Information collected will be treated in accordance with the System of Records Notice (“SORN”), CFPB.021 – CFPB
Consumer Education and Engagement Records, 83 FR 23435. The Bureau will not obtain or access any answers or
comments you provide will not be tied to you individually. The agency will only obtain and access de-identified results
and aggregated analyses of those results. Any directly identifying information will only be used by ICF International (the
survey facilitator) and partner organizations to facilitate distribution and collection of surveys and survey responses.
Survey responses will not be shared and will be kept private except as required by law.
This collection of information is authorized by Pub. L. No. 111-203, Title X, Sections 1013 and 1022, codified at 12 U.S.C.
§§ 5493 and 5512.
Your participation is voluntary, and you may withdraw participation at any time.
Paperwork Reduction Act
According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required
to respond to a collection of information unless it displays a valid OMB control number. The OMB control number for
this collection is 3170-0067. It expires on XX/XX/XXXX. The time required to complete this information collection is
estimated to average approximately 5 minutes per response. Comments regarding this collection of information,
including the estimated response time, suggestions for improving the usefulness of the information, or suggestions for
reducing the burden to respond to this collection should be submitted to the Consumer Financial Protection Bureau
(Attention: PRA Office), 1700 G Street NW, Washington, DC 20552, or by email to [email protected].

Page 4