TMR Tots LEVEL 2 - Certificate & Day 2 Forms

TOTS LEVEL 2 - Day 2
Name As You Want On Your Certificate*

First NameLast NameCredentials
Email*
example@example.com
Cell Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Name Of The Instructor :*

Dr. Susan BlumDr. Kristin SandersDr. Mona Patel
Date ( If taking Live/Live-online please put the last date of the seminar. If taking it as Homestudy please put today's date)*

MonthDayYear
Date
SEMINAR TYPE: LIVE (if taken online Sat/Sun for all but MTs), LIVE ONLINE (if taken Sat/Sun for MTs), ONLINE (if not taken on Sat/Sun ie. Homestudy)
SEMINAR City, State (OPTIONAL unless taking LIVE at location)
LICENSE NUMBER (S) & STATE(S)
How would you rate this Seminar (1 star - sucks, 5 stars - Awesome)*
Evaluation Questions :
Please rate on a scale of 1-5 to the following questions : (1 = Poor, 5 = Excellent)
1. Your overall satisfaction with the course ? (1-5)*
2. Current Level Of confidence you have of TMR TOTS?*
3. Ability you have to begin introducing TMR Tots on Monday?*
4. Confidence in recommending this course to others ?*
Rate The Following Components Of This Program
5. The information received was useful and beneficial -*

Strongly AgreeAgreeDisagreeStrongly Disagree
6. The program met the stated learning objectives - *

Strongly AgreeAgreeDisagreeStrongly Disagree
7. The presentation style enhanced my learning experience - *

Strongly AgreeAgreeDisagreeStrongly Disagree
8. The program faculty was responsive to questions/comments - *

Strongly AgreeAgreeDisagreeStrongly Disagree
9. The educational materials(manuals, handouts, forms) were useful - *

Strongly AgreeAgreeDisagreeStrongly Disagree
10. The learning assessment (surveys, forms, quiz etc) was appropriate - *

Strongly AgreeAgreeDisagreeStrongly Disagree
11. What did you like the most about this program ? *
12. What did you like the least about this program ? *
13. Did you feel that there was commercial bias or influence in this activity ?*

YesNo
If the above answer is Yes, please explain -
14. Identify topics you would like to have presented at future meetings - *
Please rate the following components of this program -
15. Registration Process -*

ExcellentGoodFairPoor
16. Program Faculty*

ExcellentGoodFairPoor
17. Location*

ExcellentGoodFairPoor
18. Was the program Faculty Knowledgeable regarding the content of their presentation ?*

YesNo
19. Was the program Faculty Relevant regarding the content of their presentation ?*

YesNo
20. Was the program Faculty Effective regarding the content of their presentation ?*

YesNo
If you have answered No, to any of the above 3 questions, please explain
Please rate the following components of this program -
21. The Presentations met my expectations - *

Strongly AgreeAgreeDisagreeStrongly Disagree
22. The Program Faculty style was appropriate for the materials presented - *

Strongly AgreeAgreeDisagreeStrongly Disagree
23. The Program Faculty was responsive to questions/comments - *

Strongly AgreeAgreeDisagreeStrongly Disagree
24. The Program met my objectives - *

Strongly AgreeAgreeDisagreeStrongly Disagree
25. The Knowledge & Information received is useful and beneficial to me - *

Strongly AgreeAgreeDisagreeStrongly Disagree
General Comments -
UPLOAD ALL DAY 2 PICTURES OF FORMS
UPLOAD HERE: TAKE PICS OF FORMS ON CAMERA. HIT BROWZE FILES AND THEN GO TO PHOTO GALLERY AND SELECT PICS OF FORMS.*

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TOTS LEVEL 2 - Day 2

Evaluation Questions :

Please rate on a scale of 1-5 to the following questions : (1 = Poor, 5 = Excellent)

Rate The Following Components Of This Program

Please rate the following components of this program -

Please rate the following components of this program -