* 1. Please fill out the following fields:

* 2. Please rate the following:

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

* 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.?

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

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

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

* 7. Optional contact information: