HRTW Evaluation

Questions with a [*] require an answer.

[*] 1.Please check the type of activity for which you are completing this report.

technical assistance

presentation

dissemination of materials

[*] 2.Please provide a brief description of the activity.

[*] 3.Date the activity was initiated

[*] 4.Date the activity was completed

[*] 5. What was the reason that you conducted this activity ( Please check all that apply):

It was requested (specify by whom and for what purpose)

It was initiated by one or more members of the HRTW team

Other (please specify by whom and for what purpose)

[*] 6.Through what venue did you conduct this activity?

On-site (e.g. conferences, meetings)

e-mail

Snail Mail

Video ( e.g. conferencing, recording)

Audio ( e.g. conferencing, recording other than on the telephone)

Phone

Listerv

Web

Other