CES FEEDBACK/EVALUATION FORM

I.

USC-CES
Form 2

Profile of the Activity

Title of Activity
Venue/Location of the Activity

Inclusive Date/s

Nature of the Activity (please check/tick the appropriate item)

[ ] Lecture/Seminar
[ ] Skills Training
[ ] Community Outreach

[ ] Relief Operations
[ ] Exposure/Immersion
[ ] Project Development

Program Area (please check/tick the appropriate item)

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Value Formation and Life Long Learning

Health
Environment Management
Issue Advocacy and Human Rights Promotion
Building of Christian Communities
Emergency Response

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Topic Area (please check/tick the appropriate item)

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Literacy and Numeracy

Psychosocial Support
Emergency Response
Relief Operations
Health and Wellness
Environmental Advocacy
Spirituality and Values Formation

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Institutional Development
Carolinian Mission Program
Carolinian Prison Ministry
Governance and Public Service Accountability
Nation-building Initiatives
Others, please specify __________________________

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Issue Advocacy & Promotion of Human Rights

Newsletter Production
Networking and Linkages
Documentation and Archives
Leadership and Teambuilding
Community Organizing
Others, please specify __________________________

College/School/Unit Responsible (please check/tick the appropriate item)

[ ] CES Office

[ ] CAS,

[ ] COED,

[ ] COE,

[ ] SHCP,

[ ] SOLG,

[ ] CAFA,
[ ] SBE,

[ ] Support Unit,

II. Quantitative Ratings

Please put a check/tick mark in the box that corresponds to your rating for each aspect of the activity as
enumerated below. Check/Tick NA if the aspect if Not Applicable. Note: You may decide to change the
specific aspects or dimensions depending on the nature of your CES.
Rating Scale: 5 Outstanding

4 Very Good
3 Good
Applicable

2 Fair

1 Poor

Aspects or Dimensions

NA Not

1. The flow, organization, and protocols of the activity were pre-arranged by the
organizers
2. An orientation or briefing was done prior to the activity
3. The orientation or briefing ably prepared the volunteers for the activity
4. All needed logistical support were provided to all participants
5. There was strict adherence to the rules set by the organizers
6. The student and faculty volunteers acted with proper decorum
7. The expected outputs and outcomes of the activity were accomplished
8. All needed materials were prepared
9. All student and faculty volunteers were competent
10. All student and faculty volunteers were cooperative and understanding
11. The facilities appropriated were ample for the activity
12. The venue was appropriate
13. There was abundant provision of food
14. A transportation support was enough for all
Please
encircle
the most favorable
answer.
15.
A decent
accommodation
was provided
1. Should this activity/or the like be organized again?
YES
NO
2. What is your overall Rating for the activity?
University of San Carlos Community Extension Services Office
5 Outstanding
4 Very Good
3 Good
2 Fair
1 Poor
Pelaez St., Cebu City, Philippines 6000 +63 32 2531000 loc. 196 ces_usc@yahoo.com

N
A

III. Comments and Recommendations

1. What was your most important learning from this activity?

2. Based on your observation, what was the best behavior/attitude exhibited by you or by the other
volunteers during the activity?

3. Based on your observation, what was the worst behavior/attitude exhibited by you or by the other
volunteers during the activity?

4. Please share to us your suggestions as to how this, and other future activities, can be improved.

5. Other comments.

University of San Carlos Community Extension Services Office

Pelaez St., Cebu City, Philippines 6000 +63 32 2531000 loc. 196 ces_usc@yahoo.com

By (optional)

Designation/Position

Date Completed

University of San Carlos Community Extension Services Office

Pelaez St., Cebu City, Philippines 6000 +63 32 2531000 loc. 196 ces_usc@yahoo.com

Received By