Participant Self-Evaluation Form: Day One

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Incident Response to Terrorist Bombings

Participant Handouts Instructor Guide

PARTICIPANT SELF-EVALUATION FORM


Use this form to conduct a daily self-assessment of your participation and performance
during class and range activities. This short exercise can help you evaluate whether you
are making the most of the learning opportunities available in the IRTB Course, and
recognize ways to improve and keep learning. Submit the form to your instructors at the
end of class on Day Four.

NAME: _______________________________________________________________

DAY ONE:
Please circle the appropriate box to rate your participation today:
1 2 3
Level of I did not offer ideas, I occasionally made I often made
engagement ask questions, or comments and asked comments and asked
volunteer answers. questions to questions to
contribute to class contribute to class
and group and group
discussions. discussions.
Listening I can improve my I tried to maintain I actively and
efforts to listen and respectful attention respectfully listened to
maintain attention. but didn’t always instructors and peers.
succeed.

DAY TWO:
Please circle the appropriate box to rate your participation today:
1 2 3
Level of I did not offer ideas, I occasionally made I often made
engagement ask questions, or comments and asked comments and asked
volunteer answers. questions to questions to
contribute to class contribute to class
and group and group
discussions. discussions.
Listening I can improve my I tried to maintain I actively and
efforts to listen and respectful attention respectfully listened to
maintain attention. but didn’t always instructors and peers.
succeed.

January 2017 Version 01.2017 Page E-1


Emergency Operations Sensitive
Incident Response to Terrorist Bombings
Participant Handouts Instructor Guide

DAY THREE:
Please circle the appropriate box to rate your participation today:
1 2 3
Level of I did not offer ideas, I occasionally made I often made
engagement ask questions, or comments and asked comments and asked
volunteer answers. questions to questions to
contribute to class contribute to class
and group and group
discussions. discussions.
Listening I can improve my I tried to maintain I actively and
efforts to listen and respectful attention respectfully listened to
maintain attention. but didn’t always instructors and peers.
succeed.

DAY FOUR
Please circle the appropriate box to rate your participation today:
1 2 3
Level of I did not offer ideas, I occasionally made I often made
engagement ask questions, or comments and asked comments and asked
volunteer answers. questions to questions to
contribute to class contribute to class
and group and group
discussions. discussions.
Listening I can improve my I tried to maintain I actively and
efforts to listen and respectful attention respectfully listened to
maintain attention. but didn’t always instructors and peers.
succeed.

January 2017 Version 01.2017 Page E-2


Emergency Operations Sensitive

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