Fire Rescue Training Instructor Survey 12-13

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* 1. Student Number - such as "FA04". If you do not have a student number assigned as part of your course, enter n/a.

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* 2. Date and time of class.

Start

Date

Time

AM/PM

End

Date

Time

AM/PM

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* 3. Please identify the COURSE you attended. Please complete 1 evaluation form for 1 class, please do not combine responses.

	EMS	Fire
Course	Course EMS menu	Course Fire menu

Other (please specify)

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* 4. What was the SUBJECT of the class which you attended?

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* 5. Where was the class session held?

Fire/Rescue Training Center

Mobile Structual Fire Trainer

Burn Building Facility

Off Site

Station 01

Station 02

Station 03

Station 04

Station 05

Station 07

Station 08

Station 09

Station 10

Station 11

Station 13

Other

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* 6. What was the Instructor's name?

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* 7. Instructor Appearance:

Casual

Suit

Uniform

VDFP

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* 8. Rate the Following Elements.

	1 - Poor	2	3	4	5	6	7	8	9	10 - Excellent
Instructor Appearance	Instructor Appearance 1 - Poor	Instructor Appearance 2	Instructor Appearance 3	Instructor Appearance 4	Instructor Appearance 5	Instructor Appearance 6	Instructor Appearance 7	Instructor Appearance 8	Instructor Appearance 9	Instructor Appearance 10 - Excellent
Classroom Appearance	Classroom Appearance 1 - Poor	Classroom Appearance 2	Classroom Appearance 3	Classroom Appearance 4	Classroom Appearance 5	Classroom Appearance 6	Classroom Appearance 7	Classroom Appearance 8	Classroom Appearance 9	Classroom Appearance 10 - Excellent
Seating	Seating 1 - Poor	Seating 2	Seating 3	Seating 4	Seating 5	Seating 6	Seating 7	Seating 8	Seating 9	Seating 10 - Excellent
Environment	Environment 1 - Poor	Environment 2	Environment 3	Environment 4	Environment 5	Environment 6	Environment 7	Environment 8	Environment 9	Environment 10 - Excellent

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* 9. Classroom Apearance:

Not Set up

Unorganized

Setup

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* 10. Seating was:

Cramped

Appropriate

Too Large

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* 11. Classroom Environment:

Cramped

Appropriate

Too Large

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* 12. Was Attendance Taken?

Yes

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* 13. Classroom set-up - Instructor Delivery

	1 - Poor	2	3	4	5	6	7	8	9	10 - Excellent
Instructor Guide	Instructor Guide 1 - Poor	Instructor Guide 2	Instructor Guide 3	Instructor Guide 4	Instructor Guide 5	Instructor Guide 6	Instructor Guide 7	Instructor Guide 8	Instructor Guide 9	Instructor Guide 10 - Excellent
Audio/Visual	Audio/Visual 1 - Poor	Audio/Visual 2	Audio/Visual 3	Audio/Visual 4	Audio/Visual 5	Audio/Visual 6	Audio/Visual 7	Audio/Visual 8	Audio/Visual 9	Audio/Visual 10 - Excellent
Training Equip.	Training Equip. 1 - Poor	Training Equip. 2	Training Equip. 3	Training Equip. 4	Training Equip. 5	Training Equip. 6	Training Equip. 7	Training Equip. 8	Training Equip. 9	Training Equip. 10 - Excellent
Materials Effective	Materials Effective 1 - Poor	Materials Effective 2	Materials Effective 3	Materials Effective 4	Materials Effective 5	Materials Effective 6	Materials Effective 7	Materials Effective 8	Materials Effective 9	Materials Effective 10 - Excellent

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* 14. Instructor Guide

Not Visible

Visible/Not Used

Utilized

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* 15. A/V Equip/Aids

Not Visible

Visible/Not Used

Utilized

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* 16. Were Materials Effective

Yes

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* 17. Instructor Delivery/Technique

	1 - Poor	2	3	4	5	6	7	8	9	10 - Excellent
Instructor	Instructor 1 - Poor	Instructor 2	Instructor 3	Instructor 4	Instructor 5	Instructor 6	Instructor 7	Instructor 8	Instructor 9	Instructor 10 - Excellent
Motivation	Motivation 1 - Poor	Motivation 2	Motivation 3	Motivation 4	Motivation 5	Motivation 6	Motivation 7	Motivation 8	Motivation 9	Motivation 10 - Excellent
Overview	Overview 1 - Poor	Overview 2	Overview 3	Overview 4	Overview 5	Overview 6	Overview 7	Overview 8	Overview 9	Overview 10 - Excellent
Presentation	Presentation 1 - Poor	Presentation 2	Presentation 3	Presentation 4	Presentation 5	Presentation 6	Presentation 7	Presentation 8	Presentation 9	Presentation 10 - Excellent
Lesson Summary	Lesson Summary 1 - Poor	Lesson Summary 2	Lesson Summary 3	Lesson Summary 4	Lesson Summary 5	Lesson Summary 6	Lesson Summary 7	Lesson Summary 8	Lesson Summary 9	Lesson Summary 10 - Excellent

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* 18. The Instructor Appeared...

Not Prepared

Prepared

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* 19. Motivation for the class:

No Motivation/Introduction

Motivation/Introduction was provided

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* 20. Overview of the class:

No Overview

An Overview was provided

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* 21. Presentation:

	1 - Poor	2	3	4	5	6	7	8	9	10 - Excellent
Instructor Voice	Instructor Voice 1 - Poor	Instructor Voice 2	Instructor Voice 3	Instructor Voice 4	Instructor Voice 5	Instructor Voice 6	Instructor Voice 7	Instructor Voice 8	Instructor Voice 9	Instructor Voice 10 - Excellent
Delivery	Delivery 1 - Poor	Delivery 2	Delivery 3	Delivery 4	Delivery 5	Delivery 6	Delivery 7	Delivery 8	Delivery 9	Delivery 10 - Excellent
Technique	Technique 1 - Poor	Technique 2	Technique 3	Technique 4	Technique 5	Technique 6	Technique 7	Technique 8	Technique 9	Technique 10 - Excellent
Lesson Summary	Lesson Summary 1 - Poor	Lesson Summary 2	Lesson Summary 3	Lesson Summary 4	Lesson Summary 5	Lesson Summary 6	Lesson Summary 7	Lesson Summary 8	Lesson Summary 9	Lesson Summary 10 - Excellent

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* 1. Student Number - such as "FA04". If you do not have a student number assigned as part of your course, enter n/a.

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* 2. Date and time of class.

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* 3. Please identify the COURSE you attended. Please complete 1 evaluation form for 1 class, please do not combine responses.

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* 4. What was the SUBJECT of the class which you attended?

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* 5. Where was the class session held?

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* 6. What was the Instructor's name?

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* 7. Instructor Appearance:

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* 8. Rate the Following Elements.

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* 9. Classroom Apearance:

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* 10. Seating was:

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* 11. Classroom Environment:

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* 12. Was Attendance Taken?

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* 13. Classroom set-up - Instructor Delivery

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* 14. Instructor Guide

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* 15. A/V Equip/Aids

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* 16. Were Materials Effective

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* 17. Instructor Delivery/Technique

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* 18. The Instructor Appeared...

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* 19. Motivation for the class:

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* 20. Overview of the class:

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* 21. Presentation:

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* 22. Would you recommend using this Instructor again?

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* 23. Comments: Instructor Appearance / Classroom Set-up

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* 24. Comments: Instructional Materials

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* 25. Comments: Instructor Delivery

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* 26. Comments: Recommendation