Technical Assistance Evaluation

Thank you for taking the time to complete this evaluation.

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* 2. TA Dates

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* 3. Name of Program/Facility

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* 4. Classroom

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* 5. Name of Teacher/Provider

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* 6. E-Signature (please type your full name)

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* 7. Please select one response per row.

  Strongly Disagree Disagree Neither Agree nor Disagree Agree Strongly Agree
This staff person was prompt in responding to my request for service.
This person was knowledgeable about the area(s) in which I requested assistance.
This staff person was able to assist me in additional resources (people and/or materials), if needed.
The need for service was or is in the process of being met to my satisfaction.
Overall, this was a positive experience for me.
I feel confident in my ability to apply the knowledge and skills I gained through technical assistance.

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* 8. Did you implement any strategies offered by the TA staff? 

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* 9. What was one strategy that your center/classroom implemented?

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* 10. What could be better? 

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* 11. I would like future assistance from this staff person. 

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* 12. If yes, what is needed?

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