Workshop Evaluation Form Page 2

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Degree of Change
For each of the following four types of change, please indicate the degree of change you have experienced as a
result of this workshop by circling one of the four rating numbers:
Type of Change
None
Slight
Moderate
Much
1. Informational Change: an increase in your awareness and
1
2
3
4
understanding of the subject matter of the training program.
2. Behavioral Change: an increase in your ability to apply the
1
2
3
4
subject matter of the training program.
3. Attitudinal Change: a modification of your beliefs and
perceptions related to the subject matter of the training
1
2
3
4
program.
4. Motivational Change: an increase in your desire to be
involved with activities related to the subject matter of the
1
2
3
4
training program.
Demographics
Please complete the following four items by marking the appropriate box or writing on the provided line:
 Male
 Female
1. Gender:
 Less than a High School Diploma
 Master Degree
2. Education:
 High School Diploma or equivalent
 Specialist Degree
 Bachelor Degree
 Doctorate Degree
3. Role:
 Special education teacher
 Parent
 General education teacher
 Paraeducator
 Early intervention provider
 University faculty
 Early preschool provider
 Administrator
 Other
4. School System/Agency (if
Name:
applicable):
 City School System
 County School System
Optional
May we contact you for additional information about this workshop, if needed?
Name: _________________________________________ Day telephone: (_______)_______-___________
E-mail address: ___________________________________________________________________________
We hope you benefited from this SIG workshop. Thank you for participating and for your commitment to
educating all students in Alabama. If you would like more information about the activities of the SIG visit
our website at:
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