Roundtable Feedback
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Name
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Email
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Company/Organization
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Role/Title
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Ethnicity
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Name of Roundtable Attended
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Date / Time
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Gender
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How Would You Rate Your Overall Experience?
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How satisfied were you with the quality of discussions?
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How relevant were the topics discussed to your interests or work?
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Somewhat Relevant
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What did you like most about the event?
What did you like least about the event?
What suggestions do you have for improving the event?
How likely are you to attend a similar event in the future?
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Who should be invited to have a seat at a future roundtable?
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Nominate a participant for an upcoming round table.
How would you like to continue engagement with us?
Tell us your preferences for how you would like to stay connected? (I.E. Email blasts, phone call, etc.)
Would you or your organization be willing to sponsor or host a future roundtable?
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No
Maybe
Can you help us secure a venue or would you like to become part of the team? Don’t be shy, All support is welcome!
Which type of extended engagment will you find most valuable?
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Additional Roundtables
Collaborative Projects
Mentorship
Networking Events
Workshops
Online Forums or Discussions
All of the Above
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