Speakers Bureau Host Evaluation

Organization/Institution Name

Type

Is your school a...

Community CollegeHistorically Black College or University (HBCU)Asian American and Native American Pacific Islander-Serving Institution (AANAPISI)Hispanic -Serving Institution (HSI)Tribal CollegeOther Minority Serving InstitutionNone of the aboveGraduate/Professional School

First Name

Last Name

Type of event

Type of Event (Other)

Format of Event

Chapter Involvement

Approximate Number of Attendees

Please enter whole number

Speaker(s)?

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Speaker (Active Minds Staff Name)

Speaker (Other)

Engagement Assessment

What is your overall assessment of the event?

	Strongly Agree	Somewhat Agree	Somewhat Disagree	Strongly Disagree
The Active Minds staff provided timely and accurate pre-event information regarding planning and logistics.
The information presented was beneficial for our audience.
The session felt responsive to the needs of our institution/organization.
The speaker(s) was professional and easy to work with.
I would recommend an Active Minds engagement to other institutions/organizations.
I would consider planning another event with Active Minds in the future.

What would you say could have improved the event?

What other topics could Active Minds cover that you would consider bringing to your community?

Testimonial

Would you be willing to offer a brief testimonial on behalf of Active Minds?

Testimonial:

Is it okay for us to use your name, title, company logo and affiliation along with your testimonial?

Please include any pictures taken at the event.