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MLTS Community Partner Evaluation

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* 1. Please fill out the following fields:

Employee's Name

Dates of Service

Total Hours Served

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* 2. Please rate the following:

	Strongly Agree	Agree	Undecided	Disagree	Strongly Disagree	Not Applicable
The MCCCD employee augmented my agency’s service delivery.	The MCCCD employee augmented my agency’s service delivery. Strongly Agree	The MCCCD employee augmented my agency’s service delivery. Agree	The MCCCD employee augmented my agency’s service delivery. Undecided	The MCCCD employee augmented my agency’s service delivery. Disagree	The MCCCD employee augmented my agency’s service delivery. Strongly Disagree	The MCCCD employee augmented my agency’s service delivery. Not Applicable
There has been sufficient communication between MCCCD and my agency.	There has been sufficient communication between MCCCD and my agency. Strongly Agree	There has been sufficient communication between MCCCD and my agency. Agree	There has been sufficient communication between MCCCD and my agency. Undecided	There has been sufficient communication between MCCCD and my agency. Disagree	There has been sufficient communication between MCCCD and my agency. Strongly Disagree	There has been sufficient communication between MCCCD and my agency. Not Applicable
The MCCCD employee was dedicated and committed to their service work.	The MCCCD employee was dedicated and committed to their service work. Strongly Agree	The MCCCD employee was dedicated and committed to their service work. Agree	The MCCCD employee was dedicated and committed to their service work. Undecided	The MCCCD employee was dedicated and committed to their service work. Disagree	The MCCCD employee was dedicated and committed to their service work. Strongly Disagree	The MCCCD employee was dedicated and committed to their service work. Not Applicable
The MCCCD employee worked effectively with my staff and others.	The MCCCD employee worked effectively with my staff and others. Strongly Agree	The MCCCD employee worked effectively with my staff and others. Agree	The MCCCD employee worked effectively with my staff and others. Undecided	The MCCCD employee worked effectively with my staff and others. Disagree	The MCCCD employee worked effectively with my staff and others. Strongly Disagree	The MCCCD employee worked effectively with my staff and others. Not Applicable
The time invested by the MCCCD employee was sufficient to make a real contribution to the agency.	The time invested by the MCCCD employee was sufficient to make a real contribution to the agency. Strongly Agree	The time invested by the MCCCD employee was sufficient to make a real contribution to the agency. Agree	The time invested by the MCCCD employee was sufficient to make a real contribution to the agency. Undecided	The time invested by the MCCCD employee was sufficient to make a real contribution to the agency. Disagree	The time invested by the MCCCD employee was sufficient to make a real contribution to the agency. Strongly Disagree	The time invested by the MCCCD employee was sufficient to make a real contribution to the agency. Not Applicable
The MCCCD employee had sufficient skills and abilities to fulfill the role and responsibilities of the position.	The MCCCD employee had sufficient skills and abilities to fulfill the role and responsibilities of the position. Strongly Agree	The MCCCD employee had sufficient skills and abilities to fulfill the role and responsibilities of the position. Agree	The MCCCD employee had sufficient skills and abilities to fulfill the role and responsibilities of the position. Undecided	The MCCCD employee had sufficient skills and abilities to fulfill the role and responsibilities of the position. Disagree	The MCCCD employee had sufficient skills and abilities to fulfill the role and responsibilities of the position. Strongly Disagree	The MCCCD employee had sufficient skills and abilities to fulfill the role and responsibilities of the position. Not Applicable
The MCCCD employee played an important role in our program.	The MCCCD employee played an important role in our program. Strongly Agree	The MCCCD employee played an important role in our program. Agree	The MCCCD employee played an important role in our program. Undecided	The MCCCD employee played an important role in our program. Disagree	The MCCCD employee played an important role in our program. Strongly Disagree	The MCCCD employee played an important role in our program. Not Applicable
I would like more contact or participation with MCCCD employees.	I would like more contact or participation with MCCCD employees. Strongly Agree	I would like more contact or participation with MCCCD employees. Agree	I would like more contact or participation with MCCCD employees. Undecided	I would like more contact or participation with MCCCD employees. Disagree	I would like more contact or participation with MCCCD employees. Strongly Disagree	I would like more contact or participation with MCCCD employees. Not Applicable
Overall, I am satisfied with MCCCD’s program.	Overall, I am satisfied with MCCCD’s program. Strongly Agree	Overall, I am satisfied with MCCCD’s program. Agree	Overall, I am satisfied with MCCCD’s program. Undecided	Overall, I am satisfied with MCCCD’s program. Disagree	Overall, I am satisfied with MCCCD’s program. Strongly Disagree	Overall, I am satisfied with MCCCD’s program. Not Applicable

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* 3. Did your organization benefit from the MCCCD employee’s involvement in your agency in terms of number of additional clients served, benefits from products produced, dollar value of services provided, etc.?

Yes

No

If yes, please explain

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* 4. How do you think the MCCCD employee benefited from their experiences with your organization?

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* 5. Do you have any other comments, suggestions, and recommendations?

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* 6. May we contact you to discuss your experience with this program further?

Yes

No

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* 7. Optional contact information:

Name

Email Address

Phone Number