Organization/Institution Name TypePlease select... School Business Other Is your school a...Community CollegeHistorically Black College or University (HBCU)Asian American and Native American Pacific Islander-Serving Institution (AANAPISI)Hispanic -Serving Institution (HSI)Tribal CollegeOther Minority Serving InstitutionNone of the aboveGraduate/Professional School First Name Last Name Email Type of eventPlease select... Speaker Story, Keynote, or Workshop V-A-R: Validate, Appreciate, Refer Training QPR: Question, Persuade, Refer Suicide Prevention Training Mental Health In The Workplace (Active Minds @Work) Training Other Type of Event (Other) Format of EventPlease select... Virtual In Person Chapter InvolvementPlease select... A chapter was not involved A chapter was a program collaborator A chapter was a primary host Approximate Number of Attendees Please enter whole number Speaker(s)? Please select... Dayna Altman Kevin Berthia Brandon Bond Kevin Briggs Carli Bushoven Pablo Campos Colleen Coffey Becky Fein Donovan Taylor Hall Meg Hutchinson Dr. Kristen Lee Alison Malmon Jade Mathis Aisha Moore Stacy Pershall Kai Roberts David Romano Anthony Sartori Abraham Sculley Greg Vogt Frank Warren Ivy Watts Na Eun "Jiggy" Yoon Micheal Zibilich Alex Cory Aaron Machbitz Sanyika Calloway (Hold down Ctrl or Command for multiple selections) Speaker (Active Minds Staff Name) Speaker (Other) Engagement Assessment What is your overall assessment of the event?Please select... Outstanding Very Good Good Acceptable Unacceptable Strongly Agree Somewhat Agree Somewhat Disagree Strongly Disagree The Active Minds staff provided timely and accurate pre-event information regarding planning and logistics. The information presented was beneficial for our audience. The session felt responsive to the needs of our institution/organization. The speaker(s) was professional and easy to work with. I would recommend an Active Minds engagement to other institutions/organizations. I would consider planning another event with Active Minds in the future. What would you say could have improved the event? What other topics could Active Minds cover that you would consider bringing to your community? Testimonial Would you be willing to offer a brief testimonial on behalf of Active Minds?Please select... Yes No Testimonial: Is it okay for us to use your name, title, company logo and affiliation along with your testimonial?Please select... Yes No Please include any pictures taken at the event. Contact Information
