Safety Program Survey

"*" indicates required fields

URL

This field is for validation purposes and should be left unchanged.

Which program did you participate in?*

Such as Defensive Driving, Kansas Active Shooter Mitigation (KASM), etc.

Instructor's Name

Technical Trooper Tiffany Baylark

Technical Trooper Jodi Clary

Technical Trooper Tod Hileman

Technical Trooper Anthony Calderon

Technical Trooper Wesley Gilmore

Technical Trooper Gary Boles

Other

When did you take the program?

MM slash DD slash YYYY

I found this program to be beneficial.*

Strongly agree	Agree	Disagree	Strongly disagree

My instructor communicated well with the class.*

Strongly agree	Agree	Disagree	Strongly disagree

My instructor was prepared for the program.*

Strongly agree	Agree	Disagree	Strongly disagree

The program material was beneficial to me.*

Strongly agree	Agree	Disagree	Strongly disagree

I would recommend this program to others.*

Strongly agree	Agree	Disagree	Strongly disagree

What did you like about this program?

If you could change this program, what changes would you make?

What other types of programs or agency involvement would be beneficial to your organization?

Receive an email copy of this form.

Email address

This field is not part of the form submission.

General Headquarters
122 SW 7th Street
Topeka, KS 66603

Report a road hazard or erratic driver call: *47, or *KTA (Turnpike)