ICS Professional Development Evaluation Form

Personal Information

Email Address * Please enter a valid email address

Full Name * Please enter your name

Role at ICS *

What is your role at ICS?

Please select your role

Event Details

Event Name * Please enter the event name

Location *

Where was the PD event conducted?

Please enter the event location

Start Date *

Start date of the event

Please select the event date

Days Attended *

Number of days you attended

Please enter the number of days

Type of Event *

Please select the event type

Event Information

Event Description *

Provide a brief description of the event and its primary objective

Please provide an event description

Professional Development Goals *

How did this event relate to your or the school's PD goals?

Please describe how this relates to PD goals

Event Evaluation

Overall Satisfaction *

Overall, how effectively did this event meet your expectations?

Not at All

1 2 3 4 5

Completely

Please rate overall satisfaction

Instructor Satisfaction *

Overall, how effective was the presenter(s) preparation, style, delivery?

Not at All

1 2 3 4 5

Completely

Please rate instructor satisfaction

Application Satisfaction *

To what extent did the event provide you with useful ideas that you can apply?

Not at All

1 2 3 4 5

Completely

Please rate application satisfaction

Recommend this Event? *

Would you recommend this event to others?

Plan to Share Learning? *

I have a plan to share my learning with a PLC or department

Please make a selection

Reflection & Implementation

Summary of What I Learned * Please provide a summary

Implementation Item 1 *

What and how am I going to implement one thing I learned?

Please describe at least one implementation item

Implementation Item 2 Optional

Reimbursement

Do you need a reimbursement for this PD? *

Yes No

Please select an option

Personal Information

Event Details

Event Information

Event Evaluation

Reflection & Implementation

Reimbursement

Evaluation Submitted!