Peer Counselors ONLY

WIC Breastfeeding Support-Level 2 Training Evaluation

Please complete the following evaluation. You will receive an email confirming completion of the evaluation and steps receiving your certificate of completion.

* Indicates required field.

First Name *

Last Name *

Preferred Name (optional)

Are you employed in a local WIC agency? *

Yes

No

Select the name of the local WIC agency where you are employed from the drop-down list below. *

What is/are your role(s) within the WIC Program? Please check all that apply. *

Employer or community organization name: *

Position or Role: *

Work Email Address *

Please confirm your work email address *

Supervisor's Contact Information

Supervisor's First Name: *

Supervisor's Last Name: *

Supervisor's Email Address: *

Confirm Supervisor's Email Address: *

Training Session Evaluation

Please select the training session attended. *

January 9, 10, 11, 22, 23, 25, 2024 (Region 3)

February 13, 14, 15, 26, 27, and 29, 2024 (Region 2)

March 12, 13, 19, 20, 26, and 27, 2024 (Region 1)

April 9, 10, 16, 17, 23, and 24, 2024 (Region 3)

May 2, 3, 14, 15, 21, and 22, 2024 (Region 2)

July 16, 17, 23, 24, 30, and 31, 2024 (Region 1)

August 13, 14, 20, 21, 27, 28, 2024 (Region 3)

The training covered the objectives described. *

This training will be useful in my role. *

What did you like about the WIC Breastfeeding Support-Level 2 Training? *

Do you have any suggestions for improvements to the WIC Breastfeeding Support-Level 2 Training? *