Pillowcase Project Chapter Feedback

Name of Your American Red Cross Chapter*

Your Name*

Your Email*

City and State (of Presentation)*

Inclusive Dates of Pilot*

Program Preparation

Level of support from National Headquarters in the preparation for the pilot.*

Not enough
Right amount
Too much

Level of input that was requested from you by National Headquarters requested in preparation for the pilot.*

Not enough
Right amount
Too much

Did you have any difficulties recruiting sites for the pilot presentations?*

Yes
No

If YES, please describe your difficulties.

Did you have any difficulties recruiting for Pillowcase Project presenters?*

Yes
No

If YES, please describe your difficulties.

Pilot Implementation Guide

Did you use the Pilot Implementation Guide?*

Yes
No

If YES, please answer the following:

Was the Pilot Implementation Guide clear enough for your planning purposes?

Yes
No

For your planning purposes, the Pilot Implementation Guide was:

Very helpful
Somewhat helpful
Not very helpful
Very unhelpful

Did the Pilot Implementation Guide include all the information you needed?

Yes
No

If NO, what additional information did you need?

If you have any suggestions for improvements for the planned Project Implementation Guide, please explain:

Presenter Training Materials

Did you use the Presenter Training materials when preparing your presenters for the pilot?*

Yes
No

If YES, please anwer the following:

Was the content of the Presenter Training Materials clear enough for your planning purposes?

Yes
No

For your training needs, the content of the Presenter Training Materials was:

Very helpful
Somewhat helpful
Not very helpful
Very unhelpful

Did the Presenter Training Materials include all the information you needed?

Yes
No

If NO, what additional information did you need?

If you have any suggestions for improvements to the Presenter Training Materials, please explain:

Presenter's Guide

Did you read through the Presenter's Guide?*

Yes
No

If YES, please rate the following:

Was the content of the Presenter's Guide clear?

Yes
No

For your project needs, the content of the Presenter's Guide was:

Very helpful
Somewhat helpful
Not very helpful
Very unhelpful

Did the Presenter's Guide include all the information you needed?

Yes
No

If NO, what additional information did you need?

If you have any suggestions for improvements to the Presenter's Guide, please explain:

Curriculum Materials

How much time did it take you to prepare the materials for each presentation?*

More time than similar presentations
The same amount of time as similar presentations
Less time than similar presentations

If YES, please rate the following:

How useful were the Hazards Supplements considering the 10 minute time limit?

Very useful
Somewhat useful
Not very useful
Very unuseful

What would you do to change the Hazards Supplements?

How clear is the intended use/activity for the leave-behinds? (posters, workbooks, pillowcases and markers, other teacher materials)

Very clear
Somewhat clear
Not very clear
Very unclear

How, if at all, would you change the leave-behinds used by The Pillowcase Project?

Pillowcase Project Reporting Requirements

Please consider the Pillowcase Project Reporting Requirements when rating the following:

The length of the Presenter Training feedback form

Too long
Right length
Too short

The length of the Presenter Survey form

Too long
Right length
Too short

The length of the Pre/Post Tests

Too long
Right length
Too short

The information captured in the Presentation Tracking form

Meets my monitoring needs
Does not meet my monitoring needs

Please indicate the relevance of The Pillowcase Project to your Chapter's community preparedness education priorities

Very relevant
Relevant
Somewhat relevant
Not at all relevant

Please rate your overall experience with The Pillowcase Project Pilot

We will be conducting interviews and Focus Group Discussions with the Pilot Sites. Prior to those conversations, if there is anything that you would like us to know about your experiences with the Pilot, please include them here: