ࡱ> 241 Kbjbj 4"K hhhhh||||$|X(,2hWhhWWW|hhWWWW" LW(0XWWWWhWdWX .:   AccessERC Minigrant Evaluation for professional development minigrant Congratulations on successfully completing minigrant [number], [the project name] by attending [event] on [date(s)] that was funded by a minigrant from AccessERC. To assist us in our reporting to NSF, we would like you to provide the following data in addition to the evaluation described in your approved project proposal. Our hope is to gather information that indicates to what degree our minigrant projects have supported our goal to increase the success of students with disabilities in completing engineering degrees and entering careers in engineering fields. Please provide the following basic demographic information: 1. Which best describes you? ___College/university administrator ___College/university faculty ___College/university staff ___High school teacher ___Middle school teacher ___K-5 teacher ___Pre-K teacher ___Graduate student ___Undergraduate student (4-year school) ___Undergraduate student (2-year school) ___Other: 1a. If administrator/staff/faculty, what is your field of expertise?___ 1b. If K-12 teacher, what is your teaching specialty (select one)? ___General ___Math ___Science ___Technology ___Other: 2. Gender: 3. Ethnicity and/or Race (please mark all that apply): ___Hispanic or Latino ___American Indian or Alaska Native ___Asian ___African American ___Native Hawaiian / Pacific Islander ___White 4. Do you have a disability? ___No ___Yes 4a. If yes, what is the nature of your disability: ___Psychological/psychiatric condition ___Aspergers/autism spectrum ___Learning disorder ___ADD/ADHD ___Blind or visual impairment ___Deaf or hard-of-hearing ___Speech impairment ___Physical/orthopedic/mobility ___Acquired/traumatic brain injury ___Systemic health/medical condition ___Other: Please answer the following questions regarding the event: 5. Explain how knowledge, skills, and/or contacts gained at this event will immediately impact your work. 6. How did attendance at this event promote the interest, participation, and/or success of individuals with disabilities in engineering careers, directly or indirectly? 7. How would you rate the value of attendance at this event? ___Not successful ___Successful ___More successful than anticipated 8. What were the immediate and anticipated short-term outcomes associated with attendance at this event? 9. What long-term outcomes do you anticipate associated with attendance at this event? 10. To what extent do you believe that the anticipated long-term outcomes might materialize? ___Probably not at all (I dont plan to apply anything I gained by attending this event) ___Slightly (its a start I have more information on this topic) ___Moderate (I expect to use what I gained and/or share with others) ___Extensive (I have specific plans to use what I gained and/or share with others) 11. Would you like to attend an event like this again? ___Yes ___No Please explain: 12. Would you recommend that others attend an event like this? ___Yes ___No Please explain: 13. Did you discover any unexpected outcomes as a result of attendance at this event? ___Yes ___No If yes, please describe: 14. 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