CCE 4H Youth Survey

Things I'd like to learn! Cornell Cooperative Extension's Student Interest Survey 3-2011.

Please note that all info provided will be used for future planning and program growth opportunities. This survey is for the 4H Youth.

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1. My age is:

My age is: 7 & Under

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2. Please fill out the following information:

Please fill out the following information: ZIP CODE:

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3. Things I'd like to do or learn about ... (check one circle for each of the following interest areas) * Please note that this info will be used for future planning and program growth opportunities.

My Beautiful World, Science, and Nature

	No, not me!	Maybe fun!	For sure! Sounds great!
Saving our environment - water, soil, air (field trips will include a variety of testing, etc)	Things I'd like to do or learn about ... (check one circle for each of the following interest areas) Please note that this info will be used for future planning and program growth opportunities. My Beautiful World, Science, and Nature Saving our environment - water, soil, air (field trips will include a variety of testing, etc) No, not me!	Saving our environment - water, soil, air (field trips will include a variety of testing, etc) Maybe fun!	Saving our environment - water, soil, air (field trips will include a variety of testing, etc) For sure! Sounds great!
Powering The Future - Alternative Energy	Powering The Future - Alternative Energy No, not me!	Powering The Future - Alternative Energy Maybe fun!	Powering The Future - Alternative Energy For sure! Sounds great!
Gardening for fun, food, and business	Gardening for fun, food, and business No, not me!	Gardening for fun, food, and business Maybe fun!	Gardening for fun, food, and business For sure! Sounds great!
How to build a robot! (robotics)	How to build a robot! (robotics) No, not me!	How to build a robot! (robotics) Maybe fun!	How to build a robot! (robotics) For sure! Sounds great!
Animals - raising, care, showing, and profits	Animals - raising, care, showing, and profits No, not me!	Animals - raising, care, showing, and profits Maybe fun!	Animals - raising, care, showing, and profits For sure! Sounds great!
Forestry and Land Management - take me to the woods!	Forestry and Land Management - take me to the woods! No, not me!	Forestry and Land Management - take me to the woods! Maybe fun!	Forestry and Land Management - take me to the woods! For sure! Sounds great!
Fish and Wildlife - the great outdoors	Fish and Wildlife - the great outdoors No, not me!	Fish and Wildlife - the great outdoors Maybe fun!	Fish and Wildlife - the great outdoors For sure! Sounds great!
Fossils and Rocks	Fossils and Rocks No, not me!	Fossils and Rocks Maybe fun!	Fossils and Rocks For sure! Sounds great!
Small Engines (repair and maintenance)	Small Engines (repair and maintenance) No, not me!	Small Engines (repair and maintenance) Maybe fun!	Small Engines (repair and maintenance) For sure! Sounds great!
Woodworking (let's build something!)	Woodworking (let's build something!) No, not me!	Woodworking (let's build something!) Maybe fun!	Woodworking (let's build something!) For sure! Sounds great!
Computers, inside and virtual navigation	Computers, inside and virtual navigation No, not me!	Computers, inside and virtual navigation Maybe fun!	Computers, inside and virtual navigation For sure! Sounds great!
All About Bugs - the good, the bad, and the not so ugly	All About Bugs - the good, the bad, and the not so ugly No, not me!	All About Bugs - the good, the bad, and the not so ugly Maybe fun!	All About Bugs - the good, the bad, and the not so ugly For sure! Sounds great!

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4. Things I'd like to do or learn about ... (check one circle for each of the following interest areas) * Please note that this info will be used for future planning and program growth opportunities.

Born Leader? Me For President!

	No, not me!	Maybe fun!	For sure! Sounds great!
Helping others - what makes a good volunteer and how can I help?	Things I'd like to do or learn about ... (check one circle for each of the following interest areas) Please note that this info will be used for future planning and program growth opportunities. Born Leader? Me For President! Helping others - what makes a good volunteer and how can I help? No, not me!	Helping others - what makes a good volunteer and how can I help? Maybe fun!	Helping others - what makes a good volunteer and how can I help? For sure! Sounds great!
These laws need changing! How to make a difference - learn to advocate	These laws need changing! How to make a difference - learn to advocate No, not me!	These laws need changing! How to make a difference - learn to advocate Maybe fun!	These laws need changing! How to make a difference - learn to advocate For sure! Sounds great!
Ways to effectively communicate	Ways to effectively communicate No, not me!	Ways to effectively communicate Maybe fun!	Ways to effectively communicate For sure! Sounds great!
Leadership and Personal Development	Leadership and Personal Development No, not me!	Leadership and Personal Development Maybe fun!	Leadership and Personal Development For sure! Sounds great!
Team Building - it isn't winning or losing, it's the EXPERIENCE!	Team Building - it isn't winning or losing, it's the EXPERIENCE! No, not me!	Team Building - it isn't winning or losing, it's the EXPERIENCE! Maybe fun!	Team Building - it isn't winning or losing, it's the EXPERIENCE! For sure! Sounds great!

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5. Things I'd like to do or learn about ... (check one circle for each of the following interest areas) * Please note that this info will be used for future planning and program growth opportunities.

It's MY Body and Mind and I ROCK!

	No, not me!	Maybe fun!	For sure! Sounds Great!
No victim here! Personal Safety	Things I'd like to do or learn about ... (check one circle for each of the following interest areas) Please note that this info will be used for future planning and program growth opportunities. It's MY Body and Mind and I ROCK! No victim here! Personal Safety No, not me!	No victim here! Personal Safety Maybe fun!	No victim here! Personal Safety For sure! Sounds Great!
Be My Best, Health Rocks! Healthy Choices	Be My Best, Health Rocks! Healthy Choices No, not me!	Be My Best, Health Rocks! Healthy Choices Maybe fun!	Be My Best, Health Rocks! Healthy Choices For sure! Sounds Great!
Chef Me! Welcome To My Meal	Chef Me! Welcome To My Meal No, not me!	Chef Me! Welcome To My Meal Maybe fun!	Chef Me! Welcome To My Meal For sure! Sounds Great!
Karate, Ti-Chi, Yoga, and Dance	Karate, Ti-Chi, Yoga, and Dance No, not me!	Karate, Ti-Chi, Yoga, and Dance Maybe fun!	Karate, Ti-Chi, Yoga, and Dance For sure! Sounds Great!
Theatre, Arts, and Self Awareness	Theatre, Arts, and Self Awareness No, not me!	Theatre, Arts, and Self Awareness Maybe fun!	Theatre, Arts, and Self Awareness For sure! Sounds Great!

CCE 4H Youth Survey
Exit this survey

1. Things I'd Like To Learn!

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1. My age is:

*
2. Please fill out the following information:

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3. Things I'd like to do or learn about ... (check one circle for each of the following interest areas) * Please note that this info will be used for future planning and program growth opportunities.

My Beautiful World, Science, and Nature

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4. Things I'd like to do or learn about ... (check one circle for each of the following interest areas) * Please note that this info will be used for future planning and program growth opportunities.

Born Leader? Me For President!

*
5. Things I'd like to do or learn about ... (check one circle for each of the following interest areas) * Please note that this info will be used for future planning and program growth opportunities.

It's MY Body and Mind and I ROCK!

CCE 4H Youth SurveyExit this survey

1. Things I'd Like To Learn!

*1. My age is:

*2. Please fill out the following information:

*3. Things I'd like to do or learn about ... (check one circle for each of the following interest areas) * Please note that this info will be used for future planning and program growth opportunities. My Beautiful World, Science, and Nature

*4. Things I'd like to do or learn about ... (check one circle for each of the following interest areas) * Please note that this info will be used for future planning and program growth opportunities. Born Leader? Me For President!

*5. Things I'd like to do or learn about ... (check one circle for each of the following interest areas) * Please note that this info will be used for future planning and program growth opportunities. It's MY Body and Mind and I ROCK!

CCE 4H Youth Survey
Exit this survey

*
1. My age is:

*
2. Please fill out the following information:

*
3. Things I'd like to do or learn about ... (check one circle for each of the following interest areas) * Please note that this info will be used for future planning and program growth opportunities.

My Beautiful World, Science, and Nature

*
4. Things I'd like to do or learn about ... (check one circle for each of the following interest areas) * Please note that this info will be used for future planning and program growth opportunities.

Born Leader? Me For President!

*
5. Things I'd like to do or learn about ... (check one circle for each of the following interest areas) * Please note that this info will be used for future planning and program growth opportunities.

It's MY Body and Mind and I ROCK!