Westberg Webinars General Evaluation Form

Westberg Webinars General Evaluation Form

Westberg Webinars General Evaluation Form

(Revised 2026.02)
Course Information
Webinar Name:*
Contact Hours:
Webinar Name:*
Date:*

MonthDayYear
Date
Date Completed:*
Certificate Information
Email used to register for webinar:*
Name for certificate:*

First NameLast Name
Choose one or more to describe your practice:*

RNFCNChaplain/ClergyOther
If Other, please specify
Credentials: *
Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Course and Instructor Evaluation

Please evaluate:*

	Yes	No
Can you identify one new or reinforced piece of knowledge gained from this activity?

If yes, please describe:

Please evaluate:*

	Excellent	Good	Fair
The course as a whole was:
The course content will impact/change my practice in some way:
The webinar increased my knowledge of the topic:
The webinar met my expectations:

Other topics I would like to attend:
Comments:
Should be Empty: