Oceanside Professional Development Center

Course Exit Survey/Evaluation
Long Form

Course Name:
Instructor(s):
Date(s):(ie. MM/DD/YY)
Directions: Please rate the degree to which you were able to implement the course objectives using the following key:


2 
3 
4  
5 

6
Not at all    
Inconsistently/Partly 
  
Entirely

I. Professional development teacher objectives

As the result of this professional development activity I was able to:
A.
B.
C.
   

II. Professional development student outcomes

Upon implementation students were able to:
A.
B.
C.

III. Please submit any evidence of implementation or impact (e.g. procedural checklists, logs, journal entries, student data) via...

Inter-office Mail

Teacher's Center
School #6

US Postal

Oceanside Teacher's Center
145 Merle Avenue
Oceanside, N.Y. 11572

IV. Please describe any impediments (e.g., lack of materials, support, resources, training) that need to be addressed for consistent, successful implementation to be achieved.
V. Please describe strategies that you used to make implementation easier and/or more successful.
VI. (OPTIONAL) What are some other ways that the professional development had important impact on your practice?
VII. (OPTIONAL) What are some other ways that the professional development had an important impact on student outcomes in your classroom?
General comments:
Would you like follow-up? Yes
No
Please provide contact information (phone/e-mail) below so that you can receive a confirmation e-mail with your responses to this form included. Also this will allow us to address any concerns you may have listed above. [*NOT REQUIRED]
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