Agency name

City, State

Primary Contact person

Email

Phone

Mailing address   A certificate of attendance will be mailed to this address.

Total number of audio-conference participants from this location

1. Did you encounter any difficulties with telephone connection or sound quality?
            Yes          No

     If yes, please briefly explain.
         

2. Were the objectives stated in the promotional materials met?
            Yes          No          Partially

3. Please rate overall quality of the content.
            Good          Poor          Average

4. Was the session well organized, integrated and in a logical sequence?
            Yes          No          Somewhat

5. Was the level of information appropriate for the audience
            Yes          No          Somewhat

6. Were the reference materials useful and related to the session's objectives?
            Yes          No          Somewhat

7. Was the presenter well prepared to conduct the session?
            Yes          No          Somewhat

8. Did the presenter communicate effectively?       Yes          No

9. Should this topic be offered again?      Yes          No

Please list other topics or speakers you would like to hear delivered in an audio-conference program.
       

Other comments you'd like to share?