Federal Course and Customer Specific Training Feedback S

Federal Course and Customer Specific Training Feedback Survey
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What date did your course start? (calendar picker)
Choose your instructor(s). (radio button)
Rate (instructor name)’s performance. (1-5 stars)
Think of (instructor name)’s portion of the course when answering the following (4 radio
button Likert scale)
a. Well organized and well-prepared
b. Clarified points and answered questions
c. Engaged learners
d. Would take again/another class
5. What should we know about (instructor name)’s performance and how it affected your
learning? (open text, optional field)
6. Was there another instructor?
a. If yes, questions 3-5 repeat for that instructor.
b. If no, questions proceed to #7.
7. Please select your sentiment in relation to the below statements. (4 radio button Likert scale)
a. I learned new knowledge and skills from this course.
b. I will be able to apply what I learned
c. The objectives were fulfilled.
d. The activities support learning.
8. Rate your knowledge of laws and topics covered in this course. (4 radio button Likert scale)
a. Prior to the course
b. After the course
9. How likely are to recommend this class to a friend or colleague? (select 0-10 “net promoter”
scale)
10. Have you previously attended an EEOC Training Institute course or event? (Yes/No radio
buttons)
11. How would you rate your overall experience with EEOC Training? (rate 1-5 stars)
12. Additional comments or suggestions regarding this course. (free text, optional)
13. Would you like to be contacted about your experience? (Yes/No radio button)
14. (only if Yes is selected) Please provide your name, government element, and contact
information for your preferred method (email, phone, etc.) (optional)
Privacy Act Statement
Section 705 of Title VII of the Civil Rights Act of 1964, 42 U.S.C. 2000e-4, created the EEOC’s
Technical Assistance Training Institute, through which this program is presented. The provision
of contact information on this form is voluntary. The primary use of this information will be to
allow the EEOC to contact you regarding future training opportunities. Additional disclosure of
this information may be made pursuant to the routine uses for Revolving Fund Registrations
outlined in the EEOC’s Systems of Records Notice.