Customer Satisfaction Survey Council Survey Question Title * 1. Race/Ethnicity White, alone Black or African American, alone American Indian or Alaska Native, alone Hispanic/Latino Asian, alone Native Hawaiian or Other Pacific Islander, alone Two or more races Race unknown OK Question Title * 2. Gender Female Male Other OK Question Title * 3. Geographic Area Urban Rural OK Question Title * 4. Please check the statement that best describes you. Check one box only. I am an individual with a developmental disability. I am a family member of an individual with a developmental disability. I do not have a developmental disability and I am not a family member of a person with a developmental disability. OK Question Title * 5. Are you satisfied with this Workshop series? YES, I am satisfied. NO, I am not satisfied. OK Question Title * 6. On a scale of 1 to 10 (10=highest), how would you rate this Training Conference in terms of usefulness and helpfulness? 1 Not at all Useful or Helpful 10 Extremely Useful or Helpful Clear i We adjusted the number you entered based on the slider’s scale. OK Question Title * 7. Please answer these questions with a Yes or No. Because of this Training Conference: Yes or No I am increasing my advocacy. Yes No I am increasing my advocacy. Yes or No menu I am better able to say what I want, and what is important to me. Yes No I am better able to say what I want, and what is important to me. Yes or No menu I am now participating in advocacy activities. Yes No I am now participating in advocacy activities. Yes or No menu I am serving on a cross-disability coalition, policy board, advisory board, governing body and/or serving in a leadership position. Yes No I am serving on a cross-disability coalition, policy board, advisory board, governing body and/or serving in a leadership position. Yes or No menu OK Please help us to know how your levels of independence, productivity, self-determination, integration and inclusion (ISPII*) have increased as a result of participating in this Workshop series. Evaluate yourself on a scale of 1 (lowest) to 5 (highest) for each measure. OK Question Title * 8. Independence: After participating in this Training Conference, I have become more independent* at work, home or school: *Independence means the extent to which individuals exert control and choice over their own lives. 1 Has not increased at all 5 Has increased very much Clear i We adjusted the number you entered based on the slider’s scale. OK Question Title * 9. Productivity: After participating in this Training Conference, I am more productive.* *Productivity means starting employment or a positive change in one's employment situation (better wages, hours, benefits, improved status, or job advancement. 1 Has not increased at all 5 Has increased very much Clear i We adjusted the number you entered based on the slider’s scale. OK Question Title * 10. Self Determination: After participating in this Training Conference, my self-determination* has increased. *Self-determination means the freedom to choose where and with whom to live or taking personal responsibility for personal decisions about needed supports and services. 1 Has not increased at all 5 Has increased very much Clear i We adjusted the number you entered based on the slider’s scale. OK Question Title * 11. Integration and Inclusion: After participating in this Training Conference, I have experienced more community integration and inclusion.* *Integration and inclusion means using the same community resources that are available to other citizens or fully participating in community activities. 1 Has not increased at all 5 Has increased very much Clear i We adjusted the number you entered based on the slider’s scale. OK Question Title * 12. If you have additional comments, please write them here. Thank you! OK NEXT