TRAINER EVALUATION FORM

Mail to: JCI INDIA, National Headquarter, 506 Windfall, Sahar Plaza, J. B. Nagar, Andheri (East), Mumbai 400 059
Ph: (022) – 7111 7112, E-mail: training@jciindia.in

Name of Trainer LOM

Name of Host President

Host LOM Date

Place Venue

From To Hours

1. Intimation received from JCI India NHQ /ND / Host

on
2. Confirmation sent to JCI India NHQ /ND / Host on
3. No. of participants
4. Level of Participation by Participants (kindly enclose
a brief report)
5. No. of LOM’s
6. Level of Participation by Participants (kindly enclose
a brief report)
7. Hall Arrangements
8. Catering Arrangements
9. Auditorium Arrangements
10. Accommodation: For Faculty
11. Accommodation For Participants
12. Hospitality
13. Were you able to start the programme in time? Y/N
14. If No, give reason
15. Were you able to conclude the programme in time?
Y/N
16. If No, give reason
17. Remarks, if any
18. Date of signing the claim format for the host

Place :
Date :
Signature of Trainer