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CIL-NET Webinar – Intersectionality in Centers for Independent Living: Cultural Inclusion, March 31, 2016

Satisfaction Survey

Copy of Satisfaction Survey

1. Date of presentation: *This question is required. This question requires a valid date format of MM/DD/YYYY.

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2. Participant Information:

Name (Optional)

3. Describe Yourself:

4. Highest Level of Education:

5. Years in Field:

6. Years in Current Position:

7. Please rate the following by checking the column of your choice:

Space Cell	Strongly Disagree	Somewhat Disagree	Neutral	Somewhat Agree	Strongly Agree
The presenter(s) had adequate knowledge of the topic.	The presenter(s) had adequate knowledge of the topic.: Strongly Disagree	The presenter(s) had adequate knowledge of the topic.: Somewhat Disagree	The presenter(s) had adequate knowledge of the topic.: Neutral	The presenter(s) had adequate knowledge of the topic.: Somewhat Agree	The presenter(s) had adequate knowledge of the topic.: Strongly Agree
The content was organized to promote learning.	The content was organized to promote learning.: Strongly Disagree	The content was organized to promote learning.: Somewhat Disagree	The content was organized to promote learning.: Neutral	The content was organized to promote learning.: Somewhat Agree	The content was organized to promote learning.: Strongly Agree
I would recommend this to someone else.	I would recommend this to someone else.: Strongly Disagree	I would recommend this to someone else.: Somewhat Disagree	I would recommend this to someone else.: Neutral	I would recommend this to someone else.: Somewhat Agree	I would recommend this to someone else.: Strongly Agree

8. What is the one most important thing you learned in this webinar?

9. Would your center or SILC be interested in free, individualized technical assistance on this or another topic?

10. If you answered "yes" to the question above, please give us your contact information so we can follow up with you.

Your Name
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11. Other Comments: