Participant Survey

If you participated in one of our learning modules or trainings, please complete the survey below.

Data is collected for federal reporting as required by the Assistive Technology Act of 2004. For more information visit the National Assistive Technology Act Technical Assistance and Training (AT3) Center website.

Name(required)

I am a(n):(required)

How many people will potentially benefit from the STAR training information you receive?

The category of the training I participated in was:(required)

Name of Training:

State of Residence:(required)

County of Residence:(required)

Additional Comments: