Pacific Crest Institute Assessment Form

Pacific Crest Institute Assessment Form

Please take a few minutes to share your assessment of the recent event you attended.

Name Date of Event

Institution Event Name

Department Position

Email Address Phone Number

May we e-mail you our quarterly newsletter, Reflections? (you may unsubscribe at any time)
Yes   No

May we e-mail you a FREE bi-weekly Insight? (you may unsubscribe at any time)
Yes   No

May we share your comments about this event with others?
Yes   No

Would you like to learn more about the annual Process Education conference, sponsored by the Academy of Process Educators?
Yes   No

Interest in future faculty development events offered by Pacific Crest

Please let us know your interest in the following:

I am interested in being a mentor at a Teaching Institute.
Yes   No

I am interested in coaching at a Learning-to-Learn Camp.
Yes   No

I am interested in the following Pacific Crest events. Please inform me when and where future events are being offered.

Activity Design Institute

Designing Performance Measures

Program Assessment Institute

Advanced Teaching Institute

Faculty Development Institute

Program Design Institute

Assessment Institute

  Facilitator's Institute

Research Institute

Chairperson's Institute

Facilitating On-line Learning

Strategic Planning Institute

Course Design Institute

Interactive Learning Systems

Student Success Institute

Designing Learning Objects

Leadership Institute

Teaching Institute

Interest in Pacific Crest's publications or publishing services

Please let us know your interest in the following:

I am interested in purchasing a copy of the Faculty Guidebook or getting access to the on-line version of the Faculty Guidebook

I am interested in having Pacific Crest publish my material for the following course:

I am interested in the following Pacific Crest publication:

Interest in Pacific Crest's publications or publishing services

Please let us know your interest in the following:

I am interested in learning more about Process Education

I find the Compass of Higher Education a meaningful tool for transformational change

I believe that I am a Process Educator

Feedback about the Institute

   Logistics, set-up, and organization (use the sliders to rate the following):

usefulness of
preparation materials
not useful at all slightly useful useful very useful extremely useful

quality of facilities used
very low quality low quality neutral good quality very high quality

food and refreshments
very low quality low quality neutral good quality very high quality

   Content and processes (use the sliders to rate the following):

degree to which your expectations were met
not met at all some were met most were met met all expectations beat my expectations

your level of interest in the content presented/covered
no interest at all low medium high extremely high

quality of the materials
used for the Institute
very low quality low quality neutral good quality very high quality

interest in participating in future institutes/events
no interest at all low I'll think about it high extremely high

Assess the Institute using the SII Method:

Strengths (including why):

Areas for Improvement (including how):

Insights (including significance):

Identify the two activities you found most valuable and the two activities you found least valuable:

MOST valuable

LEAST valuable

What are the two most important things you learned at the Institute?

#1 #2

Feedback about the Facilitator(s)

(use the sliders to rate the following):

effectiveness of the
facilitator(s)
not effective at all slightly effective somewhat effective effective extremely effective

pacing of activities
very poorly paced poorly paced neutral well paced very well paced

responsiveness to participant needs
not at all responsive somewhat responsive met obvious needs very responsive anticipated needs

Assess the facilitator(s) and mentors (when appropriate) using the SII Method:

Facilitator Name: Facilitator Name:

Strengths (including why):

Areas for Improvement (including how):

Insights (including significance):

Strengths (including why):

Areas for Improvement (including how):

Insights (including significance):

Please share any additional comments or feedback you may have!