AT @ Work Awareness Training Survey The PA Assistive Technology and Employment Collaborative is seeking the following information as part of our on-going evaluation of the effectiveness of the program we provide. Please assist us by completing this survey. All responses are confidential. How would you describe your role at the training seminar? a. Business owner b. Human Resources staff c. Employer d. Vocational Rehabilitation Counselor e. Other (please specify) __________________________________ County of business or organization:______________________________________ Section 1. Rate your level of agreement with these statements as a result of this training. Note that a rating of 1 is “strongly disagree” and 6 is “strongly agree” Statement: Strongly Disagree Disagree Disagree a Little Agree a Little Agree Strongly Agree 1. The meeting rooms were professional and comfortable 1 2 3 4 5 6 2. The presentation was accessible to me 1 2 3 4 5 6 3. The pacing of the training was appropriate 1 2 3 4 5 6 4. The presenters stimulated the interest and involvement of participants 1 2 3 4 5 6 5. The goals for the training were well presented 1 2 3 4 5 6 6. The content of the training was relevant to my situation or interests 1 2 3 4 5 6 7. The training increased my awareness of how I can accommodate employees in my workplace 1 2 3 4 5 6 8. I plan to review my employment practices related to assistive technology and accommodations as a result of this training. 1 2 3 4 5 6 9. I plan to modify or improve accommodations for employees who might need assistive technology as a result of this training. 1 2 3 4 5 6 Section 2. In the 1st column, rate your level of understanding BEFORE the training. In the 2nd column, rate your understanding to show any improvement AFTER the training. Note that a rating of 1 is “None” and 5 is “Very high”. TOPIC My Level of Understanding BEFORE the Seminar AFTER the Seminar None Very Low Moderate High Very High None Very Low Moderate High Very High 1. The definition of assistive technology 1 2 3 4 5 1 2 3 4 5 2. How assistive technology can remove barriers to effective job functions 1 2 3 4 5 1 2 3 4 5 3. Knowledge of AT resources in Pennsylvania 1 2 3 4 5 1 2 3 4 5 Section 3. 1. How would you rate your overall satisfaction with the training seminar? (Circle one) a. Highly Satisfied b. Satisfied c. Somewhat Satisfied d. Not satisfied 2. Do you have any other comments on the training? Your input is valuable as we plan future trainings. Thank you. For office use only Training Location:__________________________________________________________________ Training Date:__________________________________Length of Training:____________________ Trainer(s):________________________________________________________________________ 2 May08 Sept07