1999-2003 Evaluation Handbook - Section 3
- It's Your Money
- The Chartreuse Moose
- Semantic Differential Scale
- Semantic Likert-Type Scale
- CES Staff Development In-service Evaluation
- 4-H Water Camp Evaluation
- 4-H C.A.P.I.T.A.L.
- Empowering Parents of Teen Facilitators Guide
- Diet, Nutrition and Health Outcome Indicators
IT'S YOUR MONEY
Several months ago you used the "It's Your Money" materials developed by Colorado State University Cooperative Extension. We would appreciate you taking five minutes to tell us if the information was valuable to you. Please return this form to:
County Office
Mailing Address
City, State, Zip Code
- How would you rate 'It's Your Money?
- On a monthly basis, what percentage of your money do you feel you are using to a greater
satisfaction after using "It's Your Money"?
100% 80% 60% 40% 20% 10% 0%
- Would you give one or two examples of how you have benefited from "It's Your Money"?
- Have you discussed the "It's Your Money" series with other people such as family, friends, club members, work associates, etc.? With about how many people?
- Do you think other people in the state would benefit from the "It's Your Money" Information?
- After this exercise, what discoveries allowed you to "find" extra money to spend the way you want? How much money did you "find"?
- What is your sex? (Circle one)
Male Female - What is your age? (Circle one)
a. Under 18
b. 18 - 24
c. 25 - 34
d. 35 - 49
e. 50 - 64
f. 65 - 74
g. 75 or Over - What is the highest level of education that you have completed? (Circle one)
a. Less than high school graduate
b. High school graduate
c. Technical school or some college
d. College graduate or beyond - Are you employed outside the home? (Circle one)
a. Full-time
b. Part-time
c. No - Where do you live? (Circle one)
a. Rural farm
b. Rural (less than 2,500 people)
c. Urban - 2,500 - 25,000
d.Urban - 25,000 - 50,000 people
e. Urban - Over 50,000 people
Using "It's Your Money" helped me/us Circle the # of the Response
| Discuss finances | 4 | 3 | 2 | 1 |
| Identify goals | 4 | 3 | 2 | 1 |
| Understand spending | 4 | 3 | 2 | 1 |
| Improve spending | 4 | 3 | 2 | 1 |
| Control use of credit | 4 | 3 | 2 | 1 |
| Set up records | 4 | 3 | 2 | 1 |
| Keep records up-to-date | 4 | 3 | 2 | 1 |
| Reach goals this year | 4 | 3 | 2 | 1 |
| Seek assistance from qualified persons (banker, financial planner, insurance agent, etc.) | 4 | 3 | 2 | 1 |
| Feel in control of money | 4 | 3 | 2 | 1 |
| Feel less stress from money matters | 4 | 3 | 2 | 1 |
| Cut back on family arguments | 4 | 3 | 2 | 1 |
Thank you for your time. We would be interested in any other comments you have about "It's Your Money."
THE CHARTREUSE MOOSE
Please write down the last four digits of your phone number:_________________
- Some of the traditional, older ideas about how children learn to read and write have been replaced by
a newer, whole language approach. Please circle "New" if the statement describes new ideas about how
children learn language or "Old" if the statement reflects a traditional approach.
- Writing is learned after reading.
Old New - Young children's reading and writing are different from adults' but no less important.
Old New - Young children gain knowledge bout reading and writing by participating in meaningful activities.
Old New - Some children learn to read and write before they have any formal instruction.
Old New - Young children learn reading and writing by interacting with other people.
Old New
- Writing is learned after reading.
- We have listed six activities you could do to encourage language development in children of different
ages. We also have listed four age groups of children. Please write in a number on the line in front of
each activity which indicates the age group or which the activity is most appropriate. Age groups may be
used more than once.
1 = 0 to 18 Months
2 = 19 to 36 Months
3 = 3 to 5 Years
4 = 6 to 10 Years - Play a game in which children match letters and the sounds they make.
- Give kids the first line of a poem and have them make up the rest of a poem that rhymes.
- Give the child an object to practice grasping and letting go.
- Have children re-tell a story using simple puppets.
- Expand on child's two-word sentences. For example, if child says "me go" "you want to go outside."
- Hold child close and imitate whatever child says or does.
- Some people believe in teaching children to read early; others do not. Circle the "YES" after each statement you believe to be accurate and "NO" for those that are not.
- Children who learn to read before entering school will outstrip their playmates from then on.
Old New - By third grade, many children who were not taught to read before Kindergarten have just as good
reading skills as their peers who were taught to read before Kindergarten.
Old New - Some children who learn to early miss out on other important experiences.
Old New - Some children who are urged to read at a very young age develop a fear of failure.
Old New - Overall, how helpful was this workshop? (Circle One)
- Overall, how effective was this instructor? (Circle One)
Not Helpful
12 3 4 Very Helpful
5 - What future training would be of interest to you? (Circle Yes or No for each idea)
- Activities that build on children's educational TV
YES NO - Home study/monthly meeting course on science fun
YES NO - Taking care of our environment
YES NO - Encouraging good health habits in children
YES NO - Math activities for young children
YES NO - Fun ways to involve parents in your program
YES NO - Communication with young children
YES NO - Outdoor play
YES NO - Child abuse prevention and reporting
YES NO
- Activities that build on children's educational TV
- In what town or city is this workshop being given?
| Not Helpful 1 | 2 | 3 | 4 | Very Helpful 5 |
SEMANTIC DIFFERENTIAL SCALE
On the next few pages you will find four categories:
- Myself
- My Role as Parent
- My Work
- My Family Life
Eight descriptive scales are below each category and each scale is based on two concepts, such as "Weak" or "Strong." Please place one check (,/) within each scale to indicate how the concepts relate to you and how you rate yourself.
For example, if the concepts given are "Strong" and "Weak" and you feel "Strong" closely describes you, place your ( / ) as follows:
Myself
Weak______________________|_Strong
If you feel "Weak" moderately describes you, place your mark as follows:
Myself
Weak____|___________________Strong
If you feel "Strong" slightly describes you, place your mark as follows:
Myself
Weak______________|_________Strong
If both concepts seem equally associated to you, or if the concepts seem completely unrelated to the category,
or if you consider the concepts to be neutral, then place your mark in the center:
Myself
Weak____________|___________Strong
Please be sure to place a mark on each scale. Each category has eight scales, so please make a total of eight marks per category, one for each scale.
Myself
- Important______________________________________________ Unimportant
- Active_________________________________________________ Passive
- Unchanging____________________________________________ Changing
- Powerful_______________________________________________ Powerless
- Successful_____________________________________________ Unsuccessful
- Weak_________________________________________________ Strong
- Relieved_______________________________________________ Tense
- Dangerous_____________________________________________ Safe
Myself as a Parent
- Important______________________________________________ Unimportant
- Active_________________________________________________ Passive
- Unchanging____________________________________________ Changing
- Powerful_______________________________________________ Powerless
- Successful_____________________________________________ Unsuccessful
- Weak_________________________________________________ Strong
- Relieved_______________________________________________ Tense
- Dangerous_____________________________________________ Safe
SUMMATED LIKERT-TYPE SCALE
Briefly reflect on how you feel about your present work and family situation and then respond to the following general statements about yourself, your work and your family.
Please indicate the degree to which you agree with each statement by circling one of the numbers following each statement.
Key
I = Strongly Disagree
2 = Moderately disagree
3 = Slightly disagree
4 = Undecided or No Opinion
5 = Slightly Agree
6 = Moderately Agree
7 = Strongly Agree
8 = Not Applicable
| Strongly Disagree | Strongly Agree | |||||||
|---|---|---|---|---|---|---|---|---|
| I am satisfied with my life | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 |
| My life is filled with stress | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 |
| At the end of a day, I feel frustrated because I did not accomplish all that I planned to do. | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 |
| I have difficulty setting aside time for activities with my family. | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 |
| I have difficulty setting aside Time for my partner. | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 |
| The members of my family share in the care and main tenancy of our home. | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 |
| I feel pressure from parents or in-laws to spend more time at home. | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 |
| Strongly Disagree | Strongly Agree | N/A | ||||||
|---|---|---|---|---|---|---|---|---|
| I feel pressure from members of my family unit to spend more time at home. | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 |
| My work has a positive effect on my self-esteem | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 |
| I feel that I have control over my work. | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 |
| The pace of my work life is hectic. | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 |
| I consider my earnings to be fair payment for my work. | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 |
| My work schedule is not flexible. | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 |
| I feel that my work is important. | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 |
| My work life interferes with my family. | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 |
| I feel that my working Conditions are good. | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 |
| I enjoy my work. | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 |
STAFF DEVELOPMENT INSERVICE EVALUATION
DIRECTIONS: Please circle the appropriate number and write in your comments.
Strongly | Disagree |
|||
| Presenter was well organized & completed the lecture within the time allowed. | 1 | 2 | 3 | 4 |
|---|---|---|---|---|
| Presenter showed adequate knowledge of subject matter. | 1 | 2 | 3 | 4 |
| Presenter allowed sufficient time for discussion. | 1 | 2 | 3 | 4 |
| Presenter was easy to understand. | 1 | 2 | 3 | 4 |
| Subject matter pertained to my position. | 1 | 2 | 3 | 4 |
| Subject matter held my attention. | 1 | 2 | 3 | 4 |
| Material was appropriate for the subject matter. | 1 | 2 | 3 | 4 |
| Adequate facilities were provided. | 1 | 2 | 3 | 4 |
| The in-service was an appropriate use of my time. | 1 | 2 | 3 | 4 |
| I will implement at least one idea presented. | 1 | 2 | 3 | 4 |
Comments:
Improvements:
4-H WATER CAMP EVALUATION
How good was your knowledge of water BEFORE you came to the 4-H Wild Over Water Day Camp?
Please CIRCLE the numbers that show how much you knew BEFORE about.
| Where New Mexico gets its water | 4 | 3 | 2 | 1 |
|---|---|---|---|---|
| How much water there is in New Mexico | 4 | 3 | 2 | 1 |
| Natural springs in (county name) County | 4 | 3 | 2 | 1 |
| Ecosystems that affect the water in (county name) | 4 | 3 | 2 | 1 |
| Things communities can do to keep their water supplies clean | 4 | 3 | 2 | 1 |
| How clean the water is at Elephant Butte State Park | 4 | 3 | 2 | 1 |
| Water pollution | 4 | 3 | 2 | 1 |
| Water treatment | 4 | 3 | 2 | 1 |
| Water testing | 4 | 3 | 2 | 1 |
| How much water is used by people in New Mexico | 4 | 3 | 2 | 1 |
| Aquaculture | 4 | 3 | 2 | 1 |
| Hydropower | 4 | 3 | 2 | 1 |
| The importance of water for business and families | 4 | 3 | 2 | 1 |
| How much water is used by people in New Mexico and Water quality | 4 | 3 | 2 | 1 |
What was the best thing about the WOW camp?
If you could change one thing about the WOW Camp, what would it be?
Would you come to the WOW Camp again if you could?
4-H C.A.P.I.T.A.L.
Will you help us please? Your answers to the questions on the front and back of this sheet will help us to make 4-H C.A.P.I.T.A.L. as valuable and as much fun as possible for the children and for peer leaders like you.
Please CIRCLE the numbers that show how good you are at:
Good | Good | Good |
|||
| Where New Mexico gets its water | 5 | 4 | 3 | 2 | 1 |
|---|---|---|---|---|---|
| Making friends | 5 | 4 | 3 | 2 | 1 |
| Keeping friends | 5 | 4 | 3 | 2 | 1 |
| Expressing yourself so that others Understand | 5 | 4 | 3 | 2 | 1 |
| Doing what you say will do | 5 | 4 | 3 | 2 | 1 |
| Setting personal goals | 5 | 4 | 3 | 2 | 1 |
| Making decisions | 5 | 4 | 3 | 2 | 1 |
| Solving problems | 5 | 4 | 3 | 2 | 1 |
| Feeling good about yourself | 5 | 4 | 3 | 2 | 1 |
| Complimenting others | 5 | 4 | 3 | 2 | 1 |
| Making good grades in school | 5 | 4 | 3 | 2 | 1 |
| Working with young children | 5 | 4 | 3 | 2 | 1 |
| Accepting suggestions and advice | 5 | 4 | 3 | 2 | 1 |
| Challenging others to do their best | 5 | 4 | 3 | 2 | 1 |
| Being a leader | 5 | 4 | 3 | 2 | 1 |
How old are you?
Are you a male or a female?
What is your race/ethnic background?
What School do you attend?
In what area do you plan to make your career? (CIRCLE no more than three)
- Health care
- Transportation Law
- Teaching
- Art or Music
- Home-making
- Science
- Social Work
- Business
- Agriculture
- Athletics
- Construction
- Communications
- Politics/Government
- Other
EMPOWERING PARENTS OF TEENS FACILITATOR'S GUIDE
- Have you or someone on your staff used this guide?
- If you answered "YES" for number one, how was it used?
- By training facilitators
- By parent groups
- Other (please specify)
- How many groups have you used this guide with?______
- Facilitators
- Parents
- Other
- Did you find the guide easy to use?
YES NOComments:
- What changes would you suggest to make this guide more useful to Educator's such as yourself?
- Did you use the evaluation included with the guide?
- If your answer to Number 1 was "NO", do you plan to use this resource in the future? If not, please tell us why:
- Have you shared this resource with other parent educators?
YES NO
If "YES", who? (please list) - Additional Comments:
YES NO
(If "YES", please send a tabulated copy of the evaluations.)
Thank you for taking the time to fill this form out and return it to me at the following address.
The information you provide is very important to us.
Name
Address
City, State, Zip Code
DIET, NUTRITION & HEALTH OUTCOME INDICATORS
Objective One: Healthy Diet and Exercise Habits
Participants will integrate health promotion principles into their lifestyles by:
- including exercise and other personal health protection practices into daily life
- leaming about and wing the Diewry GuidelinesJorAmericam, the Food Guide Ayramid, andfood labels choose a healthy diet
- wing nutritional supplements appropriately
A. Exercise
- Balance calories with daily physical activity levels.
- Walk for at least 20 minutes three times a week.
B. Food
- Choose moderate portion sizes.
- Eat lesis fat by choosing low fat versions of meat ami dairy products.
- Eat less fat by using less oil or margarine or barter.
- Eat less fat by cooking with lower fat methods
- Eat less sugar by limiting sweetened foods such as sodas, candies, sweets.
- Eat less sodium by limiting high soclitim foods stich as salty snacks.
- Use alcohol in moderation, if at all.
- Eat different foods from all five food groups every day.
- Eat at least six servings of grains a day.
- Choose more foods from the bottom of the Food Guide Pyramid.
- Eat whole grains at lean twice a day.
- Eat at lean three servings of vegetables a day.
- Eat at least two servings of fmit a day.
- When eating meat, choose servings that are about the size of a deck of cards.
- Eat at least two servings of protein foods a day.
- Eat at least two servings of dairy or calcium-rich foods each day.
- Limit fats and sweets every day.
- Use the % Daily Value to compare nutrients on food labels to my own nutrient needs.
- Use the food label to make more nutritious choices when comparing similar foods.
Nutritional Supplements:
- Strive to get adequate nutrients from foods.
- Choose a multivitamin/mineral supplement that doesn't exceed 100% of the Daily Value for most nutrients.
- Choose a multivitamin/mineral supplement that dissolves readily.
- Choose a multivitamin/mineral supplement that is inexpensive.
- Take a multivitamin containing folate to decrease the risk of birth defects.
- Gain knowledge from reliable sources on risks and benefits of herbs before taking my.
- Check with my doctor before taking herbs.
- Do not give herbs to babies or pregnant women.
- Strive to improve health by eating healthy food and getting regular exercise instead of taking herbs.
Skeleton Survey - At Time of Lesson
County
Date
We'd like to know more about how your participation in our educational lesson has affected you. Please take a few minutes to answer these questions.
- To what extend did the lesson increase your awareness/knowledge about the following? (Circle one for each).
- As a result of attending this Lesson, you may change some of you ideas or behavior. What did you do regularly before the lesson?
- Are there any other things you plan to do differently after today's lesson?
- The Chartreuse Moose
- Semantic Differential Scale
- Semantic Likert-Type Scale
- CES Staff Development In-service Evaluation
- 4-H Water Camp Evaluation
- 4-H C.A.P.I.T.A.L.
- Empowering Parents of Teen Facilitators Guide
- Diet, Nutrition and Health Outcome Indicators
- How would you rate 'It's Your Money?
Using "It's Your Money" helped me/us Circle the # of the ResponseVery Helpful Somewhat Helpful Not Very Helpful Not Helpful At All Discuss finances 4 3 2 1 Identify goals 4 3 2 1 Understand spending 4 3 2 1 Improve spending 4 3 2 1 Control use of credit 4 3 2 1 Set up records 4 3 2 1 Keep records up-to-date 4 3 2 1 Reach goals this year 4 3 2 1 Seek assistance from qualified persons
(banker, financial planner, insurance agent, etc.)4 3 2 1 Feel in control of money 4 3 2 1 Feel less stress from money matters 4 3 2 1 Cut back on family arguments 4 3 2 1 - On a monthly basis, what percentage of your money do you feel you are using to a greater
satisfaction after using "It's Your Money"?
100% 80% 60% 40% 20% 10% 0%
- Would you give one or two examples of how you have benefited from "It's Your Money"?
- Have you discussed the "It's Your Money" series with other people such as family, friends, club members, work associates, etc.? With about how many people?
- Do you think other people in the state would benefit from the "It's Your Money" Information?
- After this exercise, what discoveries allowed you to "find" extra money to spend the way you want? How much money did you "find"?
- What is your sex? (Circle one)
- What is your age? (Circle one)
a. Under 18
b. 18 - 24
c. 25 - 34
d. 35 - 49
e. 50 - 64
f. 65 - 74
g. 75 or Over - What is the highest level of education that you have completed? (Circle one)
a. Less than high school graduate
b. High school graduate
c. Technical school or some college
d. College graduate or beyond - Are you employed outside the home? (Circle one)
a. Full-time
b. Part-time
c. No - Where do you live? (Circle one)
a. Rural farm
b. Rural (less than 2,500 people)
c. Urban - 2,500 - 25,000
d.Urban - 25,000 - 50,000 people
e. Urban - Over 50,000 people - Some of the traditional, older ideas about how children learn to read and write have been replaced by a newer, whole language approach. Please circle "New" if the statement describes new ideas about how children learn language or "Old" if the statement reflects a traditional approach.
- Writing is learned after reading.
Old New - Young children's reading and writing are different from adults' but no less important.
Old New - Young children gain knowledge bout reading and writing by participating in meaningful activities.
Old New - Some children learn to read and write before they have any formal instruction.
Old New - Young children learn reading and writing by interacting with other people.
Old New - We have listed six activities you could do to encourage language development in children of different ages. We also have listed four age groups of children. Please write in a number on the line in front of each activity which indicates the age group or which the activity is most appropriate. Age groups may be used more than once.
- Play a game in which children match letters and the sounds they make.
- Give kids the first line of a poem and have them make up the rest of a poem that rhymes.
- Give the child an object to practice grasping and letting go.
- Have children re-tell a story using simple puppets.
- Expand on child's two-word sentences. For example, if child says "me go" "you want to go outside."
- Hold child close and imitate whatever child says or does.
- Some people believe in teaching children to read early; others do not. Circle the "YES" after each statement you believe to be accurate and "NO" for those that are not.
- Children who learn to read before entering school will outstrip their playmates from then on.
Old New - By third grade, many children who were not taught to read before Kindergarten have just as good
reading skills as their peers who were taught to read before Kindergarten.
Old New - Some children who learn to early miss out on other important experiences.
Old New - Some children who are urged to read at a very young age develop a fear of failure.
Old New - Overall, how helpful was this workshop? (Circle One)
- Overall, how effective was this instructor? (Circle One)
Not Helpful
12 3 4 Very Helpful
5 - What future training would be of interest to you? (Circle Yes or No for each idea)
- Activities that build on children's educational TV
YES NO - Home study/monthly meeting course on science fun
YES NO - Taking care of our environment
YES NO - Encouraging good health habits in children
YES NO - Math activities for young children
YES NO - Fun ways to involve parents in your program
YES NO - Communication with young children
YES NO - Outdoor play
YES NO - Child abuse prevention and reporting
YES NO
- Activities that build on children's educational TV
- In what town or city is this workshop being given?
- Myself
- My Role as Parent
- My Work
- My Family Life
- Important______________________________________________ Unimportant
- Active_________________________________________________ Passive
- Unchanging____________________________________________ Changing
- Powerful_______________________________________________ Powerless
- Successful_____________________________________________ Unsuccessful
- Weak_________________________________________________ Strong
- Relieved_______________________________________________ Tense
- Dangerous_____________________________________________ Safe
- Important______________________________________________ Unimportant
- Active_________________________________________________ Passive
- Unchanging____________________________________________ Changing
- Powerful_______________________________________________ Powerless
- Successful_____________________________________________ Unsuccessful
- Weak_________________________________________________ Strong
- Relieved_______________________________________________ Tense
- Dangerous_____________________________________________ Safe
- Health care
- Transportation Law
- Teaching
- Art or Music
- Home-making
- Science
- Social Work
- Business
- Agriculture
- Athletics
- Construction
- Communications
- Politics/Government
- Other
- Have you or someone on your staff used this guide?
- If you answered "YES" for number one, how was it used?
- By training facilitators
- By parent groups
- Other (please specify)
- How many groups have you used this guide with?______
How many people were trained?
- Facilitators
- Parents
- Other
- Did you find the guide easy to use?
- What changes would you suggest to make this guide more useful to Educator's such as yourself?
- Did you use the evaluation included with the guide?
YES NO
(If "YES", please send a tabulated copy of the evaluations.) - If your answer to Number 1 was "NO", do you plan to use this resource in the future? If not, please tell us why:
- Have you shared this resource with other parent educators?
YES NO
If "YES", who? (please list) - Additional Comments:
- including exercise and other personal health protection practices into daily life
- leaming about and wing the Diewry GuidelinesJorAmericam, the Food Guide Ayramid, andfood labels choose a healthy diet
- wing nutritional supplements appropriately
- Balance calories with daily physical activity levels.
- Walk for at least 20 minutes three times a week.
- Choose moderate portion sizes.
- Eat lesis fat by choosing low fat versions of meat ami dairy products.
- Eat less fat by using less oil or margarine or barter.
- Eat less fat by cooking with lower fat methods
- Eat less sugar by limiting sweetened foods such as sodas, candies, sweets.
- Eat less sodium by limiting high soclitim foods stich as salty snacks.
- Use alcohol in moderation, if at all.
- Eat different foods from all five food groups every day.
- Eat at least six servings of grains a day.
- Choose more foods from the bottom of the Food Guide Pyramid.
- Eat whole grains at lean twice a day.
- Eat at lean three servings of vegetables a day.
- Eat at least two servings of fmit a day.
- When eating meat, choose servings that are about the size of a deck of cards.
- Eat at least two servings of protein foods a day.
- Eat at least two servings of dairy or calcium-rich foods each day.
- Limit fats and sweets every day.
- Use the % Daily Value to compare nutrients on food labels to my own nutrient needs.
- Use the food label to make more nutritious choices when comparing similar foods.
- Strive to get adequate nutrients from foods.
- Choose a multivitamin/mineral supplement that doesn't exceed 100% of the Daily Value for most nutrients.
- Choose a multivitamin/mineral supplement that dissolves readily.
- Choose a multivitamin/mineral supplement that is inexpensive.
- Take a multivitamin containing folate to decrease the risk of birth defects.
- Gain knowledge from reliable sources on risks and benefits of herbs before taking my.
- Check with my doctor before taking herbs.
- Do not give herbs to babies or pregnant women.
- Strive to improve health by eating healthy food and getting regular exercise instead of taking herbs.
- To what extend did the lesson increase your awareness/knowledge about the following? (Circle one for each).
Not
at allA lot A._____________________________ 5 4 3 2 1 B. ____________________________ 5 4 3 2 1 C. ____________________________ 5 4 3 2 1 - As a result of attending this Lesson, you may change some of you ideas or behavior. What did you do regularly before the lesson?
- Are there any other things you plan to do differently after today's lesson?
at all | |||||
| A._____________________________ | 5 | 4 | 3 | 2 | 1 |
| B. ____________________________ | 5 | 4 | 3 | 2 | 1 |
| C. ____________________________ | 5 | 4 | 3 | 2 | 1 |
What will you do regularly after this Lesson?
IT'S YOUR MONEY
Several months ago you used the "It's Your Money" materials developed by Colorado State University Cooperative Extension. We would appreciate you taking five minutes to tell us if the information was valuable to you. Please return this form to:
County Office
Mailing Address
City, State, Zip Code
Thank you for your time. We would be interested in any other comments you have about "It's Your Money."
THE CHARTREUSE MOOSE
Please write down the last four digits of your phone number:_________________
1 = 0 to 18 Months
2 = 19 to 36 Months
3 = 3 to 5 Years
4 = 6 to 10 Years
| Not Helpful 1 | 2 | 3 | 4 | Very Helpful 5 |
SEMANTIC DIFFERENTIAL SCALE
On the next few pages you will find four categories:
Eight descriptive scales are below each category and each scale is based on two concepts, such as "Weak" or "Strong." Please place one check (,/) within each scale to indicate how the concepts relate to you and how you rate yourself.
For example, if the concepts given are "Strong" and "Weak" and you feel "Strong" closely describes you, place your ( / ) as follows:
Myself
Weak______________________|_Strong
If you feel "Weak" moderately describes you, place your mark as follows:
Myself
Weak____|___________________Strong
If you feel "Strong" slightly describes you, place your mark as follows:
Myself
Weak______________|_________Strong
If both concepts seem equally associated to you, or if the concepts seem completely unrelated to the category,
or if you consider the concepts to be neutral, then place your mark in the center:
Myself
Weak____________|___________Strong
Please be sure to place a mark on each scale. Each category has eight scales, so please make a total of eight marks per category, one for each scale.
Myself
Myself as a Parent
SUMMATED LIKERT-TYPE SCALE
Briefly reflect on how you feel about your present work and family situation and then respond to the following general statements about yourself, your work and your family.
Please indicate the degree to which you agree with each statement by circling one of the numbers following each statement.
Key
I = Strongly Disagree
2 = Moderately disagree
3 = Slightly disagree
4 = Undecided or No Opinion
5 = Slightly Agree
6 = Moderately Agree
7 = Strongly Agree
8 = Not Applicable
| Strongly Disagree | Strongly Agree | |||||||
|---|---|---|---|---|---|---|---|---|
| I am satisfied with my life | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 |
| My life is filled with stress | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 |
| At the end of a day, I feel frustrated because I did not accomplish all that I planned to do. | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 |
| I have difficulty setting aside time for activities with my family. | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 |
| I have difficulty setting aside Time for my partner. | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 |
| The members of my family share in the care and main tenancy of our home. | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 |
| I feel pressure from parents or in-laws to spend more time at home. | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 |
| Strongly Disagree | Strongly Agree | N/A | ||||||
|---|---|---|---|---|---|---|---|---|
| I feel pressure from members of my family unit to spend more time at home. | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 |
| My work has a positive effect on my self-esteem | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 |
| I feel that I have control over my work. | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 |
| The pace of my work life is hectic. | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 |
| I consider my earnings to be fair payment for my work. | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 |
| My work schedule is not flexible. | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 |
| I feel that my work is important. | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 |
| My work life interferes with my family. | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 |
| I feel that my working Conditions are good. | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 |
| I enjoy my work. | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 |
STAFF DEVELOPMENT INSERVICE EVALUATION
DIRECTIONS: Please circle the appropriate number and write in your comments.
Strongly | Disagree |
|||
| Presenter was well organized & completed the lecture within the time allowed. | 1 | 2 | 3 | 4 |
|---|---|---|---|---|
| Presenter showed adequate knowledge of subject matter. | 1 | 2 | 3 | 4 |
| Presenter allowed sufficient time for discussion. | 1 | 2 | 3 | 4 |
| Presenter was easy to understand. | 1 | 2 | 3 | 4 |
| Subject matter pertained to my position. | 1 | 2 | 3 | 4 |
| Subject matter held my attention. | 1 | 2 | 3 | 4 |
| Material was appropriate for the subject matter. | 1 | 2 | 3 | 4 |
| Adequate facilities were provided. | 1 | 2 | 3 | 4 |
| The in-service was an appropriate use of my time. | 1 | 2 | 3 | 4 |
| I will implement at least one idea presented. | 1 | 2 | 3 | 4 |
Comments:
Improvements:
4-H WATER CAMP EVALUATION
How good was your knowledge of water BEFORE you came to the 4-H Wild Over Water Day Camp?
Please CIRCLE the numbers that show how much you knew BEFORE about.
| Where New Mexico gets its water | 4 | 3 | 2 | 1 |
|---|---|---|---|---|
| How much water there is in New Mexico | 4 | 3 | 2 | 1 |
| Natural springs in (county name) County | 4 | 3 | 2 | 1 |
| Ecosystems that affect the water in (county name) | 4 | 3 | 2 | 1 |
| Things communities can do to keep their water supplies clean | 4 | 3 | 2 | 1 |
| How clean the water is at Elephant Butte State Park | 4 | 3 | 2 | 1 |
| Water pollution | 4 | 3 | 2 | 1 |
| Water treatment | 4 | 3 | 2 | 1 |
| Water testing | 4 | 3 | 2 | 1 |
| How much water is used by people in New Mexico | 4 | 3 | 2 | 1 |
| Aquaculture | 4 | 3 | 2 | 1 |
| Hydropower | 4 | 3 | 2 | 1 |
| The importance of water for business and families | 4 | 3 | 2 | 1 |
| How much water is used by people in New Mexico and Water quality | 4 | 3 | 2 | 1 |
What was the best thing about the WOW camp?
If you could change one thing about the WOW Camp, what would it be?
Would you come to the WOW Camp again if you could?
YES NO
4-H C.A.P.I.T.A.L.
Will you help us please? Your answers to the questions on the front and back of this sheet will help us to make 4-H C.A.P.I.T.A.L. as valuable and as much fun as possible for the children and for peer leaders like you.
Please CIRCLE the numbers that show how good you are at:
Good | Good | Good |
|||
| Where New Mexico gets its water | 5 | 4 | 3 | 2 | 1 |
|---|---|---|---|---|---|
| Making friends | 5 | 4 | 3 | 2 | 1 |
| Keeping friends | 5 | 4 | 3 | 2 | 1 |
| Expressing yourself so that others Understand | 5 | 4 | 3 | 2 | 1 |
| Doing what you say will do | 5 | 4 | 3 | 2 | 1 |
| Setting personal goals | 5 | 4 | 3 | 2 | 1 |
| Making decisions | 5 | 4 | 3 | 2 | 1 |
| Solving problems | 5 | 4 | 3 | 2 | 1 |
| Feeling good about yourself | 5 | 4 | 3 | 2 | 1 |
| Complimenting others | 5 | 4 | 3 | 2 | 1 |
| Making good grades in school | 5 | 4 | 3 | 2 | 1 |
| Working with young children | 5 | 4 | 3 | 2 | 1 |
| Accepting suggestions and advice | 5 | 4 | 3 | 2 | 1 |
| Challenging others to do their best | 5 | 4 | 3 | 2 | 1 |
| Being a leader | 5 | 4 | 3 | 2 | 1 |
How old are you?
Are you a male or a female?
What is your race/ethnic background?
What School do you attend?
In what area do you plan to make your career? (CIRCLE no more than three)
EMPOWERING PARENTS OF TEENS FACILITATOR'S GUIDE
YES NO
Comments:
Thank you for taking the time to fill this form out and return it to me at the following address.
The information you provide is very important to us.
Name
Address
City, State, Zip Code
DIET, NUTRITION & HEALTH OUTCOME INDICATORS
Objective One: Healthy Diet and Exercise Habits
Participants will integrate health promotion principles into their lifestyles by:
A. Exercise
B. Food
Nutritional Supplements:
Skeleton Survey - At Time of Lesson
County
Date
We'd like to know more about how your participation in our educational lesson has affected you. Please take a few minutes to answer these questions.
What will you do regularly after this Lesson?