Please review the information below. If everything is correct, click “Send”. To go back and edit your entries, click “Edit”.
The following required items were not provided or are in the wrong format. Please provide the required responses and submit again:
First Name
Last Name:
Job Title:
Company/Organization:
E-mail Address:
Note: Questions with an asterisk (*) are required for submission.
1. What is your overall satisfaction of the Pre-Conference workshop?*
2. On a scale from 0 to 10, how likely would you be to recommend the Pre-Conference workshop to your colleagues?*
3. Please indicate your agreement with the following statements about the Pre-Conference Workshop:
3a. The session was well worth my time.*
3b. I learned new information.*
3c. I picked up some ideas/strategies that I expect to use.*
3d. I enjoyed the virtual connection and experience.*
4. Please rate your level of satisfaction regarding the Pre-Conference:
4a. Session Content*:
4b. Presentation Quality*:
4c. Session Value and Applicability*:
4d. Speaker/ Instructor Knowledge and Preparedness*:
5. If you answered "Dissatisfied" or "Very Dissatisfied" in questions 4a-4d, please tell us why:
6. How did this program inspire you and the strategy of your organization?
7. Questions/ Comments/ Additional Feedback on the Pre-Conference:
8. What was your main motivator(s) to register for the Pre-Conference Workshop?* (Select all that apply.)
Cost
Speaker/ Instructor
Topic/ Subject Matter
Time of Program
Other
8a. If you selected Other, please tell us what motivated you to register.
9. Please share your suggestions and ideas for future Pre-Conference topics:
10. How did you hear about our Pre-Conference Retreat? (Select all that apply.)
Attending other WCWI in-person learning opportunities
Social Media (LinkedIn, Facebook, etc.)
General Referral (WCWI Member or Non-Member)
WCWI Website
WCWI e-Newsletter, Orientation, or Information Packet
WCWI Direct (Staff) Email
Board Member Referral
Sponsoring Organization Referral
Speaker Referral
Continuing Education
If you require CHES, SHRM, and/or NWI continuing education credits, please fill out your contact information below. You will also receive a certificate of attendance for the event.
* If you do not require any continuing education credits, please continue to the bottom of the page to submit your evaluation.
Full Name:
Company:
Email:
SHRM
The WCWI is recognized by SHRM to offer Professional Development Credits (PDCs) for the SHRM-CPSM or SHRM-SCPSM. This program is valid for 3 PDCs for the SHRM-CP or SHRM-SCP. For more information about certification or recertification, please visit www.shrmcertification.org. Self report using Activity ID: 20-NZ3P3.
Please note that if you require CHES or NWI credits, all applicable fields below must be completed or CECs may not be recorded by the National Commission for Health Education Credentialing (NCHEC) and/or the National Wellness Institute (NWI).
CHES
Sponsored by the Wellness Council of Wisconsin, a designated provider of continuing education contact hours (CECH) in health education by the National Commission for Health Education Credentialing, Inc. (NCHEC). This program is designated for Certified Health Education Specialists (CHES) and/or Master Certified Health Education Specialists (MCHES) to receive up to 3.0 Category I continuing education contact hours (CECH). Your total hours will be submitted to NCHEC and you will receive an official Certificate of Completion.
CHES ID:
NWI
The National Wellness Institute (NWI) has approved the Wellness Council of Wisconsin to provide up to 3 Category 1 Continuing Education Credit (CEC) hours for NWI certification holders.
myNWI ID:
NWI Certification(s) Held:
NWI Certification Expiration Date(s):
CECs Earned:
11. Please list other CEs you would like to see offered.