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* 1. Would you be interested in having at-risk youth from nearby communities learn life skills on your
farm through working with horses and completing farm-related chores?

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* 2. How many day(s) per week would you be willing to have students come out?

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* 3. Would you allow students to work with your horses if they are deemed well-suited for the work?

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* 4. If so, please select all types of work you’d be willing to have your horse be a partner (if deemed well-
suited for the work).

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* 5. What are some chores that you could use assistance with on your farm?

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* 6. What amenities are available on your farm?

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* 7. How many horses do you have?

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* 8. What questions/concerns do you have about the program?

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* 9. Please provide your contact information (name, phone, and/or email) here so that we can discuss further.

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