Date of Presentation
/
Month
/
Day
Year
Date
Presenters name
School/organization
Number of participants
The presenter was effective:
Strongly disagree
1
2
3
4
Strongly agree
5
1 is Strongly disagree, 5 is Strongly agree
The presentation was practical for this class/group:
Strongly disagree
1
2
3
4
Strongly agree
5
1 is Strongly disagree, 5 is Strongly agree
My expectations of the presentation were met:
Strongly disagree
1
2
3
4
Strongly agree
5
1 is Strongly disagree, 5 is Strongly agree
How many times have you seen/scheduled this program?
Please Select
1
2
3
More than 3
Why did you schedule this safety program?
How did you learn about this program?
What was the most valuable aspect of this program for the class/group?
Is there anything that you would change? (content/demonstration equipment, environment, etc.)
Overall, how would you rate this program?
Poor
1
2
3
4
Excellent
5
1 is Poor, 5 is Excellent
Please verify that you are human
*
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