Parents please complete a form & help youth members complete a form.
This questionnaire will attempt to identify the interests and needs
of
4-H Horse & Pony members, leaders and parents.
Please select the appropriate response for each item.
Please complete and return to 4-H Office. Thank you !!!
Due Oct. 25, 1996.
A. Please rate the importance of the following activities provided
by
the Wayne County 4-H
Equine Developmental Committee by circling selected response:
Highly
Quite
Important
Somewhat Not
Important
Important
Important Important
5
4
3
2
1
1. Providing a Spring Warm-up/Open
Show
5 4 3 2 1
2. Providing one Learner's Day
Show
5 4 3 2 1
3. Providing 4-H Equine Protege
Program
5 4 3 2 1
4. Providing High Point Club Award
(Youth)
5 4 3 2 1
5. Providing High Point Club Award
(Adult)
5 4 3 2 1
6. Providing a 4-H
Dance
5 4 3 2 1
B. Please indicate the extent to which you agree or disagree for the
need of the following
educational, FUN opportunities.
Strongly Agree Neither
Disagree
Strongly
Agree
Disagree
SA
A
N
D SA
6. A winter FUN
activity
SA A ND SD
7. A workshop on Equine Show
Clothing
SA A ND SD
8. Two LearnerÆs Day Shows, NO Open
Show
SA A ND SD
9. One Open Show, One LearnerÆs Day
Show
SA A ND SD
10. 4-H Equine Quiz Bowl Activity
(Jeopardy)
SA A ND SD
11. 4-H
Dance
SA A ND SD
C. Please (X) or fill-in appropriate responses.
11. __ 4-H Youth Member __ 4-H Leader __ 4-H Parent
12. ____ Age of youth __ over 18 years of age
13. ____ Grade in school if youth member
14. _________ Zip code
15. ____ How many years have you been involved in 4-H?
Additional comments/suggestions, workshop ideas:
__________________________________________________________________________________________________________________________________
_________________________________________________________________
Please complete and return by October 25, 1996 to:
XXXXX
Thank you!!
PDF file of data collection instrument