I have never seen such a form in all my years of training. If you need information from the participant's manager, then you need to design the form asking the questions your organization needs information about. We do not work for your organization, so we don't know what information you need. Only you can do that.
Measurement of Training Effectiveness
However, I suspect what you are really looking for is basically the measurement of training effectiveness. I would suggest you read up on that as a first step and work from there.
https://www.google.com/search?q=meas...hrome&ie=UTF-8