Purwomartani Kalasan Sleman Yogyakarta Kode Pos 55571 Telp/Fak 0274 496925
Jl.Veteran No.8 Yogyakarta Kode Pos: 55165, telp./Fax. (0274) 376140
DATA PRIBADI
2. Umur : (a) >25 (b) 26-30 (c) 31-35 (d) 36-40 (e) >40
5. Instansi : .................................................................................
7. Hubungan dengan peserta : (a) Atasan Langsung (b) Kolega (c) Peserta
BAGIAN I (relevansi)
Pada bagian ini, mencerminkan perasaan dan penilaian Saudara terhadap kualitas
penyelenggaraan diklat yang dikuti oleh pegawai instansi Anda secara umum apakah
sesuai dengan harapan Saudara akan perkembangan kompetensi dan kualitas kerja di
Instansi Anda. Dimohon kesediaan Saudara menuliskan alasannya?
Jawab: ..............................................................................................................................
...........................................................................................................................................
...........................................................................................................................................
...........................................................................................................................................
...........................................................................................................................................
...........................................................................................................................................
...........................................................................................................................................
...........
BAGIAN II (efektif)
Pada bagian ini jawaban Saudara diharapkan dapat mencerminkan sejauhmana tingkat
pencapaian tujuan Diklat yang telah diikuti oleh pegawai di instansi Anda.
1. Berdasarkan materi pembelajaran yang diperoleh, diskusi, dan peninjauan lapangan
selama diklat, menurut pendapat Saya tujuan diklat yang dikuti oleh pegawai di instansi
anda adalah :
Jawab: ..............................................................................................................................
...........................................................................................................................................
...........................................................................................................................................
...........................................................................................................................................
...........................................................................................................................................
...........................................................................................................................................
...........................................................................................................................................
...........
2. Menurut pendapat saya, tujuan diklat sebagaimana Saya tuliskan pada nomer 1 di atas
ini sudah tercapai? Jelaskan Alasanya?
Jawab: ....................................................................................................................................
...........................................................................................................................................
...........................................................................................................................................
...........................................................................................................................................
...........................................................................................................................................
...........................................................................................................................................
...........................................................................................................................................
.....
3. Diklat yang di ikuti oleh pegawai memberikan pengaruh terhadap perubahan atau
peningkatan beberapa aspek kemampuan pada diri pegawai? Jelaskan Alasanya?
Jawab: ....................................................................................................................................
...........................................................................................................................................
...........................................................................................................................................
...........................................................................................................................................
...........................................................................................................................................
...........................................................................................................................................
...........................................................................................................................................
.....
4. Apa dukungan atasan langsung, pimpinan daerah dan kolega Saya terhadap rencana
tindak lanjut dalam melaksanakan Action Plan yang telah disusun?
Jawab: ....................................................................................................................................
.................................................................................................................................................
.................................................................................................................................................
.................................................................................................................................................
.................................................................................................................................................
.................................................................................................................................................
..................................................................................................................
5. Menurut penilaian dan perkiraan Saya, sampai saat Saya mengisi kuesioner ini – secara
keseluruhan – tujuan dan target capaian yang telah ditetapkan dalam Action?
Jelaskan?
Jawab: ....................................................................................................................................
...........................................................................................................................................
...........................................................................................................................................
...........................................................................................................................................
...........................................................................................................................................
...........................................................................................................................................
...........................................................................................................................................
.....
BAGIAN III (dampak)
Pada bagian ini jawaban Saudara diharapkan mencerminkan manfaat dan dampak yang
dihasilkan oleh pengembangan diklat yang dikuti oleh pegawai di instansi Anda. Saudara
dimohon untuk menuliskan jawaban dan alasanya?
1. Model penyusunan rencana pembangunan seperti yang diajarkan pada diklat yang
diikuti, digunakan oleh Pemda atau Instansi tempat Saya bekerja dalam menyusun
rencana aksi pengembangan kompetensi kerja yang baru? Jelaskan faktor yang paling
mendukung?
Jawab: ....................................................................................................................................
.................................................................................................................................................
.................................................................................................................................................
.................................................................................................................................................
.................................................................................................................................................
.................................................................................................................................................
..................................................................................................................
2. Berdasarkan pengamatan Saya, sampai saat saya mengisi kuesioner ini, Apa
manfaat atau dampak yang diakibatkan oleh pelaksanaan Action Plan dari diklat yang
pernah di ikuti?
Jawab: ............................................................................................................................
.........................................................................................................................................
.........................................................................................................................................
.........................................................................................................................................
.........................................................................................................................................
.........................................................................................................................................
.........................................................................................................................................
.........................
IV. Sustainabel (berkelanjutan)
---- Terima kasih atas kesediaan Saudara mengisi kuesioner ini ----