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INSTRUCTIONAL REPORT

Delivery date:
From: Until:

CATC:

City/ Country:

STP No.

Course Title:

Modules Delivered:

Lead Instructor:

April 2019
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2nd Instructor:

April 2019
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INSTRUCTIONS
This Electronic Report contains all information to be reported upon delivery of the Training Course.

This electronic document is part of the Course Delivery Report signed by instructors and must be sent in digital
format to the person designated by the CATC in charge of providing statistical data to the administrative office.

On each page, only the cells to which you must enter the relevant information are enabled. All statistical
calculations and graphic representations occur automatically. All information is protected and does not allow for
alterations and calculation errors.

This Electronic Report includes all the required reporting when the course is taught with a maximum of twenty
(20) participants and three (3) instructors. When the course is taught with fewer participants and instructors,
complete only the relevant cells and pages.

CONTENT
Presentation

Instructions

Course Participants

Attendance Report

Grade Report

Summary Opinion Questionnaire

Integral Course Evaluation

Instructor Remarks

Lead Instructor Evaluation

2nd Instructor Evaluation

Summary Validation Questionnaire

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COURSE PARTICIPANT LIST
Title: E-mail :
No. Name of Participant Country
Employer: Telephone No:
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ATTENDANCE REPORT

No. Country Name Day 1 Day 2 Day 3 Day 4 Day 5 Day 6 Day 7 Day 8 Day 9 Day 10
0 0

0
0
0
0
0
0
0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

0 0

Codes:
P Present
A Absent
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GRADES REPORT
M1 M2 M3 M4 M5 Total MT Total
No. Name
PT1.1 MT 1.1 PT2.1 MT 2.1 PT3.1 MT 3.1 PT4.1 MT 4.1 PT5.1 MT 5.1 Average Average
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Score: #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0!

PT Average MT Average Total Average

PT1.1 PT2.1 PT 3.1 PT4.1 PT5.1 M1 M2 M3 M4 M5 Total Average
MT Total Average
12.0 100.0 100.0
10.0 80.0
8.0
60.0
6.0 50.0
40.0
4.0
20.0
2.0
0.0 0.0
0.0
 SUMMARY OPINION QUESTIONNAIRE E-Report TIC/Ad
0
No. Items Module 1 Module 2 Module 3 Module 4 Module 5 Average (%)
A. Opinions About Learning Activities 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1
1 I liked the learning activities of this module ### ### ### ### ###

The learning activities of this module were

2 interesting ### ### ### ### ###

3 This module teaches many new things ### ### ### ### ###

The learning activities of this module were

4 stimulating ### ### ### ### ###

B. Opinions about “Usefulness”

1 This module was useful ### ### ### ### ###
2 This module was relevant ### ### ### ### ###
3 This module had practical value ### ### ### ### ###
4 This module was necessary ### ### ### ### ###
C. Other opinions (major statements)
2. - What did you like least about this module and
Mod.

1. - What did you like most about this module and why? why? 3. How could this module be improved?

5
 SUMMARY OPINION QUESTIONNAIRE
A. Opinions about Learning Activities

Acceptance of learning activities Interest in learning activi- Teaching of new things Learning activities were
ties stimulating

5
4
3
2
1

5 = Strongly agree 4 = agree 3 = neutral 2 = disagree 1 = strongly

disagree
B. Opinions about “Usefulness”

Usefulness of Modules Relevance of modules Practical value of Necessity of modules

modules

5
4
3
2
1
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LEAD INSTRUCTOR EVALUATION QUESTIONNAIRE SUMMARY
5 = strongly agree 4 = agree 3 = neutral 2 = disagree 1 = strongly disagree 0
No. Items Evaluation Average %
Course
Course Curriculum 5 4 3 2 1 5 4 3 2 1
1 The instructor articulated the learning objectives ensuring the trainees understood them ### ### ### ### ###
2 The objectives presented reflected the content covered ### ### ### ### ###
5
3 The instructor encouraged the trainees to participate in making classroom decisions ### ### ### ### ### 4
Instructional Techniques ### ### ### ### ### 3
2
1 The instructor provided clear directions and explanations ### ### ### ### ###
1
Classroom Management Skills
1 The instructor monitored time and paced the training accordingly ### ### ### ### ###
2 The instructor held the attention of the trainees ### ### ### ### ###
3 The instructor provided feedback and encouragement ### ### ### ### ###
Overall, the instructor demonstrated: ### ### ### ### ###
1 Resourcefulness ### ### ### ### ###
2 Creativity ### ### ### ### ###
3 Strong subject matter expertise ### ### ### ### ### Classro
4 Strong classroom training skills ### ### ### ### ###
5 Ability to motivate trainees ### ### ### ### ###
6 Good interpersonal skills ### ### ### ### ###
7 Good classroom management skills ### ### ### ### ### 5
4
COMMENTS ### ### ### ### ###
3
2
1

### #DIV/0!
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Course Curriculum Mana- Instructional Techniques

gement

5
4
3
2
1

5 = strongly agree 4 = agree 3 = neutral 2 = disagree 1 = strongly disagree

lassroom Management Skills

Overall Instructor De-
monstration

5
4
3
2
1

#DIV/0! #DIV/0! #DIV/0! #REF! #DIV/0!

#DIV/0! #DIV/0!
#DIV/0! #DIV/0!
#DIV/0! #DIV/0!
#DIV/0! #DIV/0!
#DIV/0! #REF!
#REF!
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INTEGRAL COURSE EVALUATION

1 2 3 4 5 6 7 8 9 10
Conditions Environmental conditions ###
Personal interest in the subject ###
Appropriateness of content ###
Contents Usefulness of course ###
Fulfillment of expectations ###
Theoretical knowledge ###
Clarity ###
Practices ###
Methods
Comprehension ###
Documentation ###
Total Average: #DIV/0!###
###
###
###
Environmental conditions ###
###
100
###
90
###
Documentation 80 Personal interest in ###
the subject
70 ###
60 ###
50 ###
40
30
Comprehension 20 Appropriateness of content
10
0

Practices Usefulness of course

Clarity Fulfillment of expectations

Theoretical knowledge
Average per Criterion Total Average
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Instructor Remarks
List of proposed improvements to Module content, exercises or tests 20 pts) .

Recommendations regarding schedule, facilities, entry requirements, etc. (20 pts)

Conclusions about the success of the course, trainee behaviour, instructor comptecnies, etc. (10 pts)
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Instructor Remarks
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Evaluatio
SUMMARY VALIDATION QUESTIONNAIRE 0 in
Module 1 Module 2 Module 3 Module 4 Module 5 Total Average %

Item
5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1
The instructions which were
given for the study of this 1 ###############
module were:
2 ###############
The objectives of these
module were: 3 ###############
The activities carried out in 4 ###############
connection with these
module were: 5 ###############
6 ###############
The contents of these 7
Activ
###############
module were:
8 ###############
9 ###############
10 ###############
The terminology in this
module was: 11 ###############

The visual material for this 12 ###############

module was:
13 ###############
The practical work and 14 ###############
written exercises in this
module were: 15 ###############
16 ###############
Termin
The test(s) in this module
reflected the material 17 ###############
studied:

The pace of this module was: 18 ###############

Studying this module enabled
me to learn: 19 ###############

The knowledge and skills

acquired through this module 20 ###############
will be:

What did you like most in this module? What did you like least in this module? Have you any suggestions for improvements?
Practical A
Module 1
Module 2
Module 3

Perce
Module 4
Module 5
aluation about imparted Objectives Evaluation
instruction
5 5
4 4
3 3
2 2
1 1

Activities Evaluation Contents Evaluation

5 5
4 4
3 3
2 2
1 1

Terminology Evaluation Visual Materials Evaluation

5 5
4 4
3 3
2 2
1 1

ctical Activities Evaluation Tests Evaluation

5
5
4
4
3
3
2
2
1
1

Usefulness of acquired skills

Perception of learning
5
5 4
4 3
3 2
2 1
1