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Control No. 0551-New
Expiration
Date: ##/##/####
Scientific
Exchanges Program (SEP) Evaluation [Fellow]
Please complete this form and return to: __ no later than __ weeks
after the visit to the Host Institution.
Basic Information
Your
Name and contact information (email, phone, and mailing address):
Home
Country:
Sex:
Highest education level at application:
Masters/PhD/other
(specify: )
Overall Thoughts about Your Scientific
Exchanges Program Fellowship
We are interested in learning about your experience with the
Scientific Exchanges Program Fellowship. Please indicate where
appropriate, on a scale of 1 to 5, your response to each of the
questions below, with 1 = not at all and 5 =better than
expected. For each question, explain the reason for your scoring.
Did your
experience with the Scientific Exchanges Program Fellowship match
the research experience
you expected?
Score (Please circle
your answer):
1 2 3 4 5
Explain
your answer:
Was your Mentor accessible enough to meet
your needs related to the
fellowship?
Score (Please circle
your answer):
1 2 3 4 5
Explain
your answer:
Did you feel that your research topic was an
appropriate match with your
Mentor?
Score (Please circle
your answer):
1 2 3 4 5
Explain
your answer:
Did you complete the research study you proposed in your action
plan/proposal?
Check one: YES ☐ NO
☐
Explain your answer:
Do you feel you obtained new or improved skill during your
fellowship experience? Check one:
YES ☐ NO
☐
Explain your answer:
Did the mix of
classroom, laboratory, and field activities help you achieve your
research goals?
Score
(Please circle your answer):
1 2 3 4 5
Explain
your answer:
Did the housing, transportation, and other resources provided by
your host institution meet your
expectations?
Score
(Please circle your answer):
1 2 3 4 5
Please describe any
deficiencies or particularly good experiences.
During your
12-weeks with your Host Institution did you attend any professional
development events or
conferences?
Check one:
YES ☐ NO
☐
If YES, please
include the names and dates of these events:
Have you and your Mentor planned the reciprocal visit? Check one:
YES ☐ NO
☐
Comments:
Overall, how was your experience with the
Scientific Exchanges Program Fellowship?
Score
(Please circle your answer):
1 2 3 4 5
Explain
your answer:
Impact of your Scientific Exchanges Program
Fellowship
What were your research and training goals during your Fellowship?
Were you able to accomplish them? If not, what were the difficulties
that you experienced that prevented you from doing
so?
How do you envision your participation in
this program benefiting you in the
future?
What did you learn from the other fellows in
you fellowship cohort?
How do you
envision your participation in this program benefiting your
institution in the future?
Please list specific examples of changes or improvements you will
make to your organization upon your
return.
What
information did you obtain that will be the most useful in your work
in your home country?
Has the
Scientific Exchanges Program given you new ideas or areas of
interest to pursue professionally when you return to your home
country? Please list them
below.
List 1 or 2 of
your proudest personal accomplishments during your Scientific
Exchange Program
Please upload any
materials related to your fellowship experience, including but not
limited to photos with
captions (action photos showing your working with your Mentor or
conducting research are preferred), detailed descriptions of
experiments and subsequent data gathered in tables or other
appropriate figures.
Do you give USDA permission to use your photos on its website and
other promotional materials? YES NO
Collaboration
Resulting from Your Scientific Exchanges Program Fellowship
Do you intend to continue your collaboration with your Mentor If so,
in what way will you do this?
Do you intend
to continue your collaboration with others (e.g., other scientists,
faculty, graduate students) you met through the program? If so,
please indicate the positions they hold and how you will continue
working with them.
Do you intend
to continue or initiate collaboration with other Fellows you may
have met while participating in the Scientific Exchanges Program
Fellowship. If so, in what way will you do this?
In your opinion, how could future training
programs be improved?
Please
provide any additional comments and suggestions about the Scientific
Exchanges Program and your experience.
Public
Burden Statement. 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 public reporting burden for this information
collection is estimated to average 47 minutes per response, including
the time for reviewing instructions, and completing and submitting
the collection of information.
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| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| File Modified | 0000-00-00 |
| File Created | 0000-00-00 |