PITC Training Evaluation

Program ID#__________ Classroom ID#__________

Do not write in box. For study use only.

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless such collection displays a valid OMB control number.  The valid OMB control number for this information collection is xxxx-xxxx.  The time required to complete this information collection is estimated to average 15 minutes per response, including the time to review instructions, search existing data resources, gather the data needed, and complete and review the information collection.  If you have any comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: U.S. Department of Education, Washington, D.C. 20202-4651.  If you have comments or concerns regarding the status of your individual submission of this form, write directly to: Rafael Valdivieso, U.S. Department of Education, 555 New Jersey Avenue, NW, Room 506E, Washington, D.C. 20208.

Responses to this data collection will be used only for statistical purposes. The reports prepared for this study will summarize findings across the sample and will not associate responses with a specific program or individual. We will not provide information that identifies you or your program to anyone outside the study team, except as required by law.

Your cooperation in completing this survey is needed to make the results of this study comprehensive, reliable, and timely.

PITC PQ Periodic Training & Technical Assistance Evaluation

Trainer: Host Organization and ID #:

Training Topic:  Sessions I, II, & III  Module I  Module III  Additional Module

 Module II  Module IV

Date:

Please feel free to use the back for additional writing space and/or additional comments.

	Training & Technical Assistance Evaluation	Strongly Disagree 1	Disagree 2	Agree 3	Strongly Agree 4	N/A
1	The purpose & main concepts of each session were clear to me.
2	The training sessions were interesting and enabled me to learn.
3	The technical assistance visits were helpful.
4	The PITC handouts, videos, & materials were useful to me.
5	I am able to use what I learned in my work.

	Trainer Evaluation	Strongly Disagree 1	Disagree 2	Agree 3	Strongly Agree 4	N/A
1	The Trainer appeared to be knowledgeable.
2	The Trainer was able to communicate the subject content clearly.
3	The Trainer was responsive to the questions and needs of all participants.
4	The Trainer was approachable and helped me to feel comfortable.
5	The Trainer was well organized and arrived in a timely fashion.

I have used the PITC materials in the following way(s):

As a result of the training and technical assistance, I have made the following changes in my thinking and/or actions with infants and toddlers:

As a result of the training and technical assistance, our classroom/program has made the following changes:

The trainer helped me learn by:

Others ways my Trainer could help me learn include:

Other issues I would like to address during training or technical assistance visits include:

Partners for Quality – Periodic T & TA Evaluation Form 03/03