INTERNATIONAL SOCIETY FOR PREVENTION OF CHILD ABUSE AND NEGLECT (ISPCAN) Training Registration Form Name of the participant

Primary discipline of participant (for example: social work, legal, medical, education) Primary occupation of participant 1) How long you have worked in the field of child abuse and neglect (CAN)? a) Less than 5 years b) 5-10 years c) More than 10 years 2) What proportion of your work involves responding to problems of child abuse and neglect? a) 10 20% b) 20 40% c) More than 40% 3) How well prepared is your agency to respond to the problem of child abuse and neglect? a) Not prepared b) Moderately prepared c) Very well prepared 4) Do you think that you have clear knowledge about the term child abuse and neglect? a) No knowledge b) Little knowledge c) Moderate knowledge d) Clear knowledge 5) If clear or moderate knowledge in question 4, what do you understand by the term CAN?

6) Do you have any idea about your roles and responsibilities when you come across a child abuse or neglect case? a) No idea b) Little idea c) Moderate idea d) Clear idea 7) If clear or moderate idea in question 6, please list your primary roles and responsibilities: a) c) b) d)

8) Is there any coordination among professionals with different specializations about child abuse and neglect cases? a) Yes b) No c) No knowledge 9) Why do you wish to attend the training program? a) To learn more about the subject b) To clarify roles and responsibilities in handling cases of child abuse and neglect c) To develop clear knowledge about method of handling CAN cases d) Other (please specify) (Facilitators, please feel free to add any other specific questions.)
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