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* 1. Class / workshop TITLE?

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* 2. DATE of class / workshop?

Date

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* 3. INSTRUCTOR name?

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* 4. Please respond to each item below by indicating how strongly you agree or disagree with the statement:
 

  Disagree Strongly Disagree Neutral Agree Agree Strongly N/A
a)  The information presented during this workshop was APPLICABLE to my job.
b)  The exercises conducted during the workshop were EFFECTIVE.
c)  The skills and strategies I learned in the workshop will be USEFUL to me.
d)  The HANDOUTS were helpful.
e)  The INSTRUCTOR was knowledgeable about the subject matter.
f)  The instructor encouraged participant INVOLVEMENT during the program.
g)  OVERALL, the workshop instructor(s) was/were effective.
h)  I would RECOMMEND this workshop to others.

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* 5. What specific concepts / techniques were MOST valuable to you and why?

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* 6. How will you USE the specific concepts / techniques you identified in the previous question (if applicable)?

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* 7. What specific concepts or techniques were LEAST valuable to you and why?

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* 8. Do you have any SUGGESTIONS for improving the workshop?

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* 9. Your NAME (optional)?

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* 10. Your DEPARTMENT (optional)?

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* 11. Your EMPLOYEE NUMBER (optional)?

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