Kauffman Signature Series — Provider Information









	[Facilitator Log In] 4801 Rockhill Road Kansas City, Missouri 64110 Telephone: 816-932-1000

he Kauffman Foundation would greatly appreciate your feedback concerning the Signature Series program you recently presented to your organization.

Please fill out the form below and submit it to the Kauffman Foundation. Your comments on the presentation and the materials provided will help us to continually improve the program.

And remember to send the evaluation forms you collected from those who attended the presentation to:

Sharon Tillman
Ewing Marion Kauffman Foundation
4801 Rockhill Road
Kansas City, MO 64110-2046

If you already have a Signature Series account, click here to log-in (or to retrieve your password) before completing this form.

First Name:
Last Name:
Organization:
Address1:
Address2:
City:
State/Province:
Postal Code:
Country:
Phone:
Alt. Phone:
Email:
May We Contact You?	Yes. (We may have questions about how the program went.)
Best Contact Method:	Email Phone
Best Time To Reach You:

Signature Series Program Presented:
Leading at the Speed of Growth
Attracting and Retaining Awesome People
Values-Based Decision Making

Date of presentation:
City/State of Presentation:
Attendance at presentation:

Your comments on how the presentation went:

Number of hours I put in to prepare for the program:

This amount of time was:
More than I expected
About what I expected
Less time than I expected

The materials I received to use to prepare for the presentation were:
Excellent
Adequate
Inadequate

Comments on materials received for presentation:

The audience was most responsive to the following part(s) of the presentation:
PowerPoint presentation
Video Segments
Panel Discussions
Question and Answer session
Table discussions
Developing an Action Plan
Other
If Other, please explain:

The audience was least responsive to the following part(s) of the presentation:
PowerPoint presentation
Video Segments
Panel Discussions
Question and Answer session
Table discussions
Developing an Action Plan
Other
If Other, please explain:

I would be interested in presenting another Signature Series program to my organization:
Yes No Maybe

Please enter your comments or questions about the Kauffman Signature Series programs :

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