W-2 Interest Survey for Domestic Violence Advocates

This survey is to determine the level of interest DV advocates have in participating in an overview of the W-2 Program through a distance learning course.


A red asterisk (*) indicates required questions.

  1. Would you be interested in learning more about the W-2 program?*
    Yes
    No


  1. Would you be able to participate in a training program via distance through a computer (and phone line)?*
    Yes
    No


  1. What times would work best to offer the training for your staff? (check any that would apply)*
    Morning (8-11:30 AM)
    Afternoon (1-4 PM)
    Late Afternoon (4-6 PM)
    Evening (6-9 PM)


  1. What questions do you or your staff have regarding W-2?*


  1. Have you or your staff had opportunities to work cooperatively with your local W-2 agency?*
    Yes
    No


  1. What successes have you had working with a W-2 agency?


  1. If any, what challenges have you had working with a local W-2 agency?


  1. Do you have any additional comments relating to attending a W-2 Training Program?*


  1. Please leave your contact information so we can follow-up with any questions you have:
    Name, Agency, Phone, Email*