Certificate of Completion Survey
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Community Based Organizations
Certificate of Completion Survey
Congratulations! You Have Completed Your Course!
Please answer the following questions in order to get your certificate of completion.
1. Did you complete the training by yourself or through an instructor?*
Individual web-based training
Instructor-led training
Both
2. This course taught me valuable concepts.
Strongly Disagree
Disagree
Neither Agree or Disagree
Agree
Strongly Agree
Please provide additional comments below*
3. After taking this course, I am more likely to take steps to prepare my community based organization for emergencies and disasters.*
Agree
Disagree
If you chose ‘disagree’, please provide additional comments below
4. Which of the 10 preparedness actions motivated a change in behavior?
Understand Risks
Mitigate Risks
Identify the People You Serve
Determine Essential Activities
Consider the Supply Chain
Safeguard Critical Information
Establish a Communications Plan
Cross-Train Key Individuals
Formalize Plans
Regularly Test and Update Plans
5. What could make this course better?*
6. Why did you take this course? (Select all that apply)
To fulfill a requirement
To broaden my understanding and awareness
To improve my organization's preparedness for an emergency situation
To increase my level of comfort in continuing service during an emergency
7. How did you hear about this course? (Select all that apply)
Internet search
Word of mouth
Advertisement
Social Media
Other (fill in the blank)
Comment:
8. Would you like to receive additional information about emergency preparedness?
Yes
No
If yes, please provide your email address:
9. What is the name of the Community Based Organization that you work for?
Name
10. What type of Community Based Organization do you work for?
Business
Shelter
Faith-Based Organization
Childcare Center
Voluntary Organization
Academic Institution
Other (fill in the blank)
Other (fill in the blank)
11. What is your ZIP Code?
ZIP Code
12. How do you want your name to appear on your certificate?*
Name
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