Course Program Evaluation Form

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SAMPLE EVALUATION FORM
TO BE USED AS A GUIDE ONLY
(SPONSOR LETTERHEAD)
PROGRAM EVALUATION PROGRAM NUMBER_______________
COURSE TITLE:
_
LOCATION:
COURSE DATE: ________________
We appreciate our registrants sharing their reactions to this program. Please complete this form and
return it as you leave the program.
Evaluation Rating Scale: Excellent- 5 Good - 4 Satisfactory- 3 Below Average - 2 Poor- 1
1. PRESENTERS:
Speaker
Content
Delivery
Average
2. OVERALL RATING OF THE COURSE: (PLEASE CIRCLE ONE)
Excellent - 5
Good - 4
Satisfactory- 3
Below Average- 2
Poor- 1
3. WRITTEN MATERIALS: (PLEASE CIRCLE ONE)
Excellent - 5
Good - 4
Satisfactory- 3
Below Average- 2
Poor- 1
Comments: ___________________________________________________________
How can (sponsor) better serve your need? _______________________________
CME5
SAMPLE EVALUATION FORM
TO BE USED AS A GUIDE ONLY
(SPONSOR LETTERHEAD)
PROGRAM EVALUATION PROGRAM NUMBER_______________
COURSE TITLE:
_
LOCATION:
COURSE DATE: ________________
We appreciate our registrants sharing their reactions to this program. Please complete this form and
return it as you leave the program.
Evaluation Rating Scale: Excellent- 5 Good - 4 Satisfactory- 3 Below Average - 2 Poor- 1
1. PRESENTERS:
Speaker
Content
Delivery
Average
2. OVERALL RATING OF THE COURSE: (PLEASE CIRCLE ONE)
Excellent - 5
Good - 4
Satisfactory- 3
Below Average- 2
Poor- 1
3. WRITTEN MATERIALS: (PLEASE CIRCLE ONE)
Excellent - 5
Good - 4
Satisfactory- 3
Below Average- 2
Poor- 1
Comments: ___________________________________________________________
How can (sponsor) better serve your need? _______________________________
CME5

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