 OMB
	# 1121-0277
OMB
	# 1121-0277
Date of Expiration: xx/xx/xx
OJJDP National Training and Technical Assistance Center
	
Webinar Feedback Form
Thank you for participating in the webinar “<Insert Webinar Title Here>” supported by the Office of Juvenile Justice and Delinquency Prevention (OJJDP) National Training and Technical Assistance Center (NTTAC). To better serve you, we would like to know how satisfied you are with the quality of the webinar in which you just participated. Your feedback is indispensable in our ongoing efforts to improve the support that OJJDP provides. Your participation is completely voluntary.
PRESENTER(S): pre-printed information
For Questions 1–xx, please indicate the extent to which you agree or disagree with the following statements:
1 – I Strongly Disagree with this statement (SD).
2 – I Disagree with this statement (D).
3 – I Neither agree nor disagree with this statement (N).
4 – I Agree with this statement (A).
5 – I Strongly Agree with this statement (SA).
| Presenters ________________________________ (we can adjust this to evaluate each presenter individually or all of them collectively) | SD | D | N | A | SA | 
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| Webinar | SD | D | N | A | SA | 
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How did you find out about this Webinar?
Personal invitation
Juv Just or other listserv message
NTTAC website
Other website: _______________
Other: ______________________
	
What aspects of the webinar were most helpful and why?
________________________________________________________________________________________________________________________________________________________________________________________________________________
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Was the format of the participant materials (text, PowerPoint slides, resources) helpful to you? Do you have any recommendations for making the materials more user-friendly?
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Identify three things you plan to do or change as a result of the training you received. Please be as specific as you can (e.g., actions or changes in policy, practice, procedures, or programming).
	
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What additional assistance do you or your organization need with this topic?
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What suggestions do you have for making webinars better for future participants?
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Additional comments:
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Participant Information
	
Which of the following best describes the field in which you work? (Please choose only one.)
Ancillary youth services (e.g., recreation, prevention, mentoring, after-school)
Child and family services (e.g., child welfare, adoption)
Community-based organization
Compliance monitors
Corrections
Detention
Court services
DMC coordinator
Education/schools
Faith-based organization
Information technology
Juvenile justice specialist
Law enforcement
Legal services –defense
Legal services–prosecution
Mental health
Other advocacy (e.g., GAL, CASA)
Other residential services
Parole/community corrections
Private sector/business
Probation
Problem solving/specialized courts (e.g., drug courts)
Research
SAG representative
Substance abuse
Truant youth/dropout
Youth mentoring
Other
	
How many years of experience do you have in the field of juvenile justice?
0 – 2 years
3 – 5 years
6 – 8 years
9 – 11 years
12 – 14 years
15 or more years
	
	
How would you describe the population with which you primarily work? (Check all that apply.)
At-risk youth
Children of incarcerated parents
Dependent youth
Incarcerated youth
Homeless youth
Mentally ill youth
Pre-adjudicated youth (e.g., youth awaiting a judicial outcome)
Post-adjudicated youth (e.g., youth on parole, probation, or under community supervision)
Substance using or abusing youth
Teen parents
Youth younger than 10 years of age
Youth ages 11–15 years
Youth ages 16–the legal age of adulthood in your community
Youth in the child welfare system (e.g., foster youth, adopted youth, abused/neglected youth)
Youth volunteers
Other: ____________
	
	
	 
		We will follow up with a random sample of participants to determine
		the impact of this session/event. If you would be willing to
		participate in a brief follow-up interview, please provide
		your contact information below. The information will only be used
		for the purpose of conducting the follow-up interview. The
		confidentiality of the information you provide is guaranteed.
		Name: _____________________________	Phone:
		__________________	E-mail:_____________________
		
		
		
		
		
	
| File Type | application/msword | 
| File Title | OVC TTAC - USER FEEDBACK FORM | 
| Author | goellen | 
| Last Modified By | 15067 | 
| File Modified | 2011-06-17 | 
| File Created | 2011-06-17 |