Nebraska Department of Transportation Highway Safety Office

Grant Funded Training/Conference

Evaluation Report

This evaluation report must be completed and returned with your reimbursement request.

Agency:
Name of Attendee:
Name of Conference/Training:
Dates of Conference/Training:
Location of Conference/Training:

The purpose of this evaluation report is to determine the value of the conference or training attended as it relates the enhancement of the attendees highway safety related duties, to determine if funding should be allocated for future attendees and to identify outstanding presenters.

If you attended a conference, please include the following in your narrative report:

Attach the conference agenda.

The sessions of the conference you attended, including the following:

A brief description of the content of the sessions;

Identify any outstanding presenters including their topic and name;

Rate from 1 to 5 (with 1 being low and 5 being high) the value of the session.

The overall value of the conference attended as it relates to your highway safety related duties, how you will integrate the information into your work; and, would you recommend sending future attendees.

If you attended training, please include the following in your narrative report:

Attach the training agenda or schedule.

Rate from 1 to 5 (with 1 being low and 5 being high) the value of the training.

The overall value of the training as it relates to your highway safety related duties, how you will integrate the information into your work; and, would you recommend sending future attendees.

Attach a copy of the course completion certificate.

Narrative Report:

Report Submitted By:

Signature	Type or Print Name	Date

Narrative Report (Continued) Page 2

Report Submitted By:

Signature	Type or Print Name	Date

Narrative Report (Continued) Page 3

Report Submitted By:

Signature	Type or Print Name	Date