______________________________________________________________ (Name of Sponsoring Organization)

CONTINUING EDUCATION UNIT PARTICIPANT EVALUATION

COURSE TITLE: _________________________________________________ DATE: ___________ COURSE NUMBER: ___________________ COURSE LOCATION: _________________________ YOUR NAME (OPTIONAL): __________________________________________________________ ;;;;;;;;;;;;;

COURSE EVALUATION

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On a scale of 1 to 5 as noted below, assess how you would evaluate each of the following statements: 1 ’ Lowest 1.

’

5 ’Highest

The Instructor's knowledge of the subject was: 1. __________________________________________________

__________

2. __________________________________________________

__________

3. __________________________________________________

__________

Score Score Score

2.

The Instructor's ability to present material at a level that was understandable: 1. __________________________________________________

__________

2. __________________________________________________

__________

Score Score

3. __________________________________________________

__________

3.

The course content met the course objectives:

__________

4.

The training aids/handouts used were beneficial:

__________

5.

My overall rating of the course was:

__________

Score Score Score Score

6.

General Comments: ___________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________

7.

Please list additional course topics for which you would like to see continuing education unit sessions offered: _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ CEU4EVAL.PM4

______________________________________________________________ (Name of Sponsoring Organization)

CERTIFICATION PROGRAM ATTENDANCE RECORD FOR CONTINUING EDUCATION

COURSE NAME: ________________________________________________ DATE: ____________ COURSE NUMBER: ______________________________________________

Print Full Name

Signature

____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ _____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ _____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ CEU4EVAL.PM4