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* 1. Name

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* 2. Name of Agency

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* 3. Email address to mail certificate

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* 4. Which certificate are you requesting?

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* 5. Quality of Instruction

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* 6. Knowledge and expertise of instructor

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* 7. Usefulness of program content

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* 8. Presentation was clearly organized

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* 9. Presentation met the goals/objectives of the conference

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* 10. Conference contributed new, pertinent data to my understanding of the topic.

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* 11. Technology (access to, quality of stream, help available when needed, etc.) was adequate for the conference.

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* 12. Presenters were responsive to audience participation/questions.

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* 13. Overall the conference was...

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* 14. What level of practice did this conference address?

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