paperwork burden disclosure notice omb control …€¦ · 11/15/2015 · 8. the instructor(s)...

Student Assessment of Course and InstructorsFields displayed in bold* are required and must be completed. Please print characters in CAPITAL LETTERS only using BLACK ink.

Training Provider ID*

Course Name*

Course Catalog Number*

City*

State*

- - Start Date* End Date* // //// //

ZIP Code*

End Time* Contact Hours*

Part 1: Course Information

Part 2: NTED Level 1 Evaluation Areas and Ques-

Instructor Point of Contact

Last Name*

First Name*

Knowledge/Skills/Abilities (KSAs) Level in Subject Matter Intermediate (4) Basic (3) Little (2) None (1)Advanced (5) Not Applicable (0)

1. BEFORE the course, I would rate my knowledge, skills and abilities as:

2. AFTER the course, I would rate my knowledge, skills and abilities as:

Agree (4)Neither Agreenor Disagree (3) Disagree (2)

StronglyDisagree (1)

StronglyAgree (5) Not Applicable (0)

3. The course content supported the learning objectives.

4. The course materials and learning aids effectively conveyed the course content.

Course Evaluation

Please use the scales provided and select the best answer to indicate your level of agreement with each statement. Please provide any further explanationof your ratings in the General Comments section on the back of the form. Make solid marks using BLACK ink that fill the circle completely.

7. The instructor(s) were prepared for the class.

8. The instructor(s) demonstrated thorough knowledge of the course content.

9. The instructor(s) were able to answer questions clearly and understandably.

10. The instructor(s) conducted the training in a skilled and competent manner.

11. The instructor(s) encouraged student participation.

12. The instructor(s) fostered a positive and stimulating learning environment.

13. The instructor(s) used instructional time effectively.

14. The instructor(s) covered all of the course learning objectives.

Instructor EvaluationAgree (4)

Neither Agreenor Disagree (3) Disagree (2)



18. The course content was appropriate for someone within my professional field.19. The course content was appropriate for someone with my level of experience.

Course BenefitAgree (4)




20. Overall, the course content met my needs and expectations.

21. Overall, the instructors' performance met my needs and expectations.22. Overall, the course increased my knowledge, skills and abilities. 23. I would recommend this course to my peers.

Overall RatingsAgree (4)




17.The practical exercises enhanced learning of course content. (Respond only ifcourse included practical exercises.)

15. The course provided the knowledge and skills I need to accomplish the job for

5. The time allocated to accomplish the course objectives was appropriate.

which I am receiving this training.

(If too long or too short, please explain in Question 26 on back of form.)6. The course contained useful activities to practice and reinforce the learning

objectives.

16. Based on the training received, I am fully capable of applying the skills I learnedfrom this course.

..Start Time*Convert start and end timeinto military time.

(MM/DD/YYYY) (MM/DD/YYYY)

DHS/FEMA/PNP/NPD/NTE PAPERWORK BURDEN DISCLOSURE NOTICE OMB Control Number: 1660-NEWNational Training and Education Division (NTED) FEMA Form 064-0-5 Expiration Date: 00/00/0000Public reporting burden for this data collection is estimated to average .1 hours per response. The burden estimate includes the time for reviewing instructions, searching existingdata sources, gathering and maintaining the needed data, and completing, and submitting this form. This collection of information is required and mandatory to measureperformance goals. You are not required to respond to this collection of information unless it displays a valid OMB control number. Send comments regarding the accuracy of theburden estimate and any suggestions for reducing this burden to: Information Collections Management, Department of Homeland Security, Federal Emergency ManagementAgency, 1800 South Bell Street, Arlington, VA 20598-3005, and Paperwork Reduction Project (1660-NEW). NOTE: Do not send your completed form to the above address.

Part 3: General Comments

24. Which part(s) of the course was MOST valuable to you? Please explain why.

25. Which part(s) of the course was LEAST valuable to you? Please explain why.

26. Please provide any other comments or suggestions you have for improving this course.

27. What other training is most important to you now that you have completed this course?

PLEASE PRINT

of 2

Please take a moment to elaborate upon the course instructor(s) performance. Indicate your level of agreement with the following statements by putting a circle around the appropriate number using the scale below.

Instructor 1 Name:

5 = strongly agree 4 = agree 3 = neutral 2 = disagree 1 = strongly disagree

1) The instructor presented him/herself in aprofessional manner. 5 4 3 2 1

2) The instructor spoke clearly – using appropriatetone and volume. 5 4 3 2 1

3) The instructor used words and terms that wereappropriate to my level and understanding. 5 4 3 2 1

4) The instructor remained focused on coursematerials and did not deviate into personal stories oranecdotes.

5 4 3 2 1

5) The instructor expresses course concepts in a clearand concise manner. 5 4 3 2 1

6) The instructor explained the exercises well andprovided beneficial feedback. 5 4 3 2 1

Instructor 2 Name:





5 4 3 2 1



Comments:

Comments:

of 2

Please take a moment to elaborate upon the course instructor(s) performance. Indicate your level of agreement with the following statements by putting a circle around the appropriate number using the scale below.

Instructor 3 Name:

5 = strongly agree 4 = agree 3 = neutral 2 = disagree 1 = strongly disagree





5 4 3 2 1



Instructor 4 Name:





5 4 3 2 1



Comments:

Comments:

paperwork burden disclosure notice omb control …€¦ · 11/15/2015 · 8. the instructor(s)...

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