Community Outreach Training Acknowledgement
Please complete this form to confirm your participation and understanding of the community outreach training session.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Organization or Affiliation
Training Session Date
*
-
Month
-
Day
Year
Date
Training Location
Training Topic
*
What was your role in this training?
*
Please Select
Participant
Facilitator
Volunteer
Observer
Other
Please rate your understanding of the training content
*
1
2
3
4
5
List two key points you learned from this training.
*
Do you feel prepared to apply what you learned in your outreach activities?
*
Yes
Somewhat
No
Additional Comments or Feedback
Signature
*
Submit Acknowledgement
Submit Acknowledgement
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