Form Policy Academy Par Policy Academy Par Policy Academy Participant Post Training Form

OMB No. 0930-0316

Expiration Date: XX/XX/XXXX

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Policy Academy Participant Post-Training Call Form

Introduction

Thank you for participating in the training. Please respond to these questions about the most recent coaching call and policy step you’ve completed. Your feedback will help us better serve you.

General Information

Q1. Participant name:

Q2. Participant email:

Q3. Participant organization:

Q4. Month of coaching call:

• January

• February

• March

• April

• May

• June

• July

• August

• September

• October

• November

• December

Q5. Policy step covered:

• Step 1 – Draft Policy Action Statement

• Step 2 – Engage Compliance Organizations

• Step 3 – Collect Data

• Step 4 – Develop Issue Brief

• Step 5 – Draft Policy Language

• Step 6 – Increase Public Awareness

• Step 7 – Organize and Mobilize Support

• Step 8 – Prepare & Present Policy for Adoption

• Step 9 – Support Implementation & Enforcement

• Step 10 – Evaluate

Session Feedback

Q6. Please select the extent to which to you agree or disagree with the following statements.

	Strongly disagree (1)	Disagree (2)	Neither agree nor disagree (3)	Agree (4)	Strongly agree (5)
The content of the training increased my understanding of how to engage in policy work.
I gained new knowledge and skills from the training.
I feel confident in my ability to execute the current policy steps.
The coaches provided valuable expertise and insight related to our coalition opportunities and challenges.

Q7. What information discussed was most beneficial?

Q8. What information do you wish you had discussed, but did not?

Q9. Please provide one suggestion to improve the training.

Q10. Please provide any additional feedback below.

Thank You Page

Thank you for completing the survey. If you have additional questions or concerns, please reach out to your liaison and coach.