TOTS LEVEL 3 - Day 2
Name As You Want On Your Certificate
*
First Name
Last Name
Credentials
Email
*
example@example.com
Cell Phone Number
*
Please enter a valid phone number.
Name Of The Instructor :
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Susan Blum
Kristin Sanders
Date ( If taking Live/Live-online please put the last date of the seminar.)
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-
Month
-
Day
Year
Date
SEMINAR TYPE: LIVE (if taken online for all but MTs), LIVE ONLINE (if taken for MTs)
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)
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1
2
3
4
5
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?
Rate The Following Components Of This Program
5. The information received was useful and beneficial -
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Strongly Agree
Agree
Disagree
Strongly Disagree
6. The program met the stated learning objectives -
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Strongly Agree
Agree
Disagree
Strongly Disagree
8. The program faculty was responsive to questions/comments -
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Strongly Agree
Agree
Disagree
Strongly Disagree
9. The educational materials(manuals, handouts, forms) were useful -
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Strongly Agree
Agree
Disagree
Strongly Disagree
10. The learning assessment (surveys, forms, quiz etc) was appropriate -
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Strongly Agree
Agree
Disagree
Strongly Disagree
11. What did you like the most about this program ?
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12. What did you like the least about this program ?
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13. Did you feel that there was commercial bias or influence in this activity ?
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Yes
No
If the above answer is Yes, please explain -
14. Identify topics you would like to have presented at future meetings -
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Please rate the following components of this program -
15. Registration Process -
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Excellent
Good
Fair
Poor
16. Program Faculty -
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Excellent
Good
Fair
Poor
17. Location -
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Excellent
Good
Fair
Poor
18. Was the program Faculty knowledgeable regarding the content of their presentation ?
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Yes
No
19. Was the program Faculty Relevant regarding the content of their presentation ?
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Yes
No
20. Was the program Faculty Effective regarding the content of their presentation ?
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Yes
No
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 expectation -
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Strongly Agree
Agree
Disagree
Strongly Disagree
22. The Program Faculty style was appropriate for the materials presented -
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Strongly Agree
Agree
Disagree
Strongly Disagree
23. The Program Faculty was responsive to questions/comments -
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Strongly Agree
Agree
Disagree
Strongly Disagree
24. The Program met my objectives -
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Strongly Agree
Agree
Disagree
Strongly Disagree
25. The Knowledge & Information received is useful and beneficial to me -
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Strongly Agree
Agree
Disagree
Strongly Disagree
General Comments (if any) -
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