1.	What is your full name?

2.	Which topic did you select to learn more about?
	Career
	Continual Professional Development
	Communication
	Marketing
	Mediation
	Pre-retirement
	Strategy
	Team (including Team Leader)
	Time management
	Other

	Please add further information below

3.	What was your overall goal for this event?

4.
	To what extent did you achieve your goal?	Not required		Fully		Mostly		In Part		not at all

	What did you achieve or learn?

	What did you not achieve but had hoped to?

7.	How has this event changed what you do in future?

8.	In what ways has this event changed your attitudes?

9.	What else do you need to realise your goal - or go beyond it?

11.	How useful were the following in supporting your learning?
		Very useful		useful		quite useful		Not at all		Not relevant
	The room
	The location
	The refreshments
	The timing
	The materials provided
	The subjects covered
	The consultant (coach, trainder etc)

13.	What, if anything, would have helped increase your learning further?

10.

Was the event worth the investment (of your time, finance etc)?

Yes

No

not sure

11.

Would you recommend this event to a colleague?

Yes

No

not sure

12.

May Accomplice quote you in their future publicity?

Yes

No

Should you wish Accomplice to keep in touch, please indicate any particular interest areas you may have (e.g. career, organisation or personal development) and your preferred contact points below.

	Area(s) of interest:

	Email:

	Telephone:

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