2021 Outreach Evaluation Form

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

Proposed OCC Outreach Form 081821 with Future Events DropDown

2021 Outreach Evaluation Form

OMB: 1557-0248

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Survey: Outreach Evaluation Form V3

Created on: Aug 13, 2021 10:39 AM
Last modified on: Aug 17, 2021 4:14 PM




Page 1





Outreach Evaluation Form Please provide your feedback to help us evaluate today’s event. The Office of the Comptroller of the Currency (OCC) values your feedback; your comments will assist us in developing future programs. Thank you for your participation.



Question: Please select the event:

MM/DD - Future Event 1

MM/DD - Future Event 2

MM/DD - Future Event 3

MM/DD - Future Event 4



Question: Please select the group that most closely represents you:'

Academic

Banker

Bank Director

Community and Consumer Group

Fintech

Trade Association

Other



BEGIN Table
Question: Please rate the following questions:

Table Sub-Question: The event met my expectations.

1- Strongly Disagree

2- Disagree

3- Neither Disagree nor Agree

4- Agree

5- Strongly Agree



Table Sub-Question: The speakers demonstrated their expertise.

1- Strongly Disagree

2- Disagree

3- Neither Disagree nor Agree

4- Agree

5- Strongly Agree



Table Sub-Question: The speakers were effective.

1- Strongly Disagree

2- Disagree

3- Neither Disagree nor Agree

4- Agree

5- Strongly Agree



Table Sub-Question: The information was useful.

1- Strongly Disagree

2- Disagree

3- Neither Disagree nor Agree

4- Agree

5- Strongly Agree



Table Sub-Question: The information was timely.

1- Strongly Disagree

2- Disagree

3- Neither Disagree nor Agree

4- Agree

5- Strongly Agree



Table Sub-Question: The event covered topics of interest.

1- Strongly Disagree

2- Disagree

3- Neither Disagree nor Agree

4- Agree

5- Strongly Agree


END Table of Please rate the following questions:



Question: What part of the event did you find most valuable? Why?

Long text from respondent



Question: How could we improve the event?

Long text from respondent



Question: Please provide any additional comments

Long text from respondent



Question: If you would like to be contacted regarding your feedback, please provide your name and contact information. (Optional)

Short text from respondent



Thank you for your feedback. After you click "Finish" your responses will be submitted. OMB Control No.: XXXX-XXXXExpiration Date: 03/31/20XX



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AuthorMerritt, Shaquita
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