Agricultural Education Student Information
Name: 


A red asterisk (*) indicates required questions.

  1. What is your first and last name?*


  1. What is your mailing address?
    Include street address or PO box, city, and zip*


  1. Where do you live?*
    Rural, Farm
    Rural, Non-farm
    Small town
    City


  1. What is your email address?


  1. Do you have text messaging capabilities?*
    Yes
    No


  1. Do you have a Facebook account?*
    Yes
    No


  1. What would be your preferred method to receive FFA updates and information? Mark all that apply.*
    Daily school announcements
    Locker notes/reminders
    Posters in hallway
    Chapter Meetings
    FFA Facebook posts/messages
    Chapter webpage
    Being reminded in ag class (announcements/board)


  1. What is your preferred shirt size? (Will be used for FFA/Ag Ed shirts)
    Small
    Medium
    Large
    XL
    XXL


  1. What agriculture education classes have you taken? Mark all that apply and include currently enrolled class.*
    Ag Explorations (8th grade)
    Agriscience
    Plant and Soil Science
    Animal Science
    Agribusiness
    Ag Welding
    Advanced Ag Welding
    Advanced Ag Welding (more than once)


  1. What are your current plans immediately following high school?*
    Enter the work force
    Community college
    Technical college
    4 year college or university
    Join a branch of the armed forces


  1. Are you interested in pursuing a career in the agriculture industry? Mark all that apply.*
    Yes
    No
    Considering, but not sure yet.
    I would like more information about careers in agriculture.


  1. Are you interested in pursuing a career in agricultural education? Mark all that apply.*
    Yes
    No
    Considering, but not sure yet.
    I would like more information about careers in agricultural education.


  1. Are you planning to apply for the State FFA Degree?*
    Yes, this school year.
    Yes, in the future when I meet the requirements.
    No
    Not in FFA


  1. Do you have the goal to earn the American FFA Degree? (must apply after graduating from high school)*
    Yes
    No
    Not in FFA


  1. What is the highest FFA degree you have attained thus far?*
    Not in FFA
    Discovery
    Greenhand
    Chapter
    State


  1. What areas are part of your SAE program? Mark all that apply. Use the description sheet for clarification or ask Mr. Kilgore.
    Ag Communication
    Ag Education
    Ag Mechanics Energy Systems
    Ag Mechanics Fabrication and Design
    Ag Mechanics Repair and Maintenance
    Ag Processing
    Ag Sales
    Ag Services
    Ag Research - Animals Systems
    Ag Research - Integrated Systems
    Ag Research - Plant Systems
    Beef Production
    Dairy Production
    Diversified Ag Production
    Diversified Crop Production
    Diversified Horticulture
    Diversified Livestock Production
    Emerging Agricultural Technology
    Evironmental Science and Natural Resources Management
    Equine Science
    Fiber and/or Oil Crop Production
    Food Science and Technology
    Forage Production
    Forest Mangement
    Fruit Production
    Goat Production
    Grain Production
    Home and/or Community Development
    Landscape Mangement
    Nursery Operations
    Outdoor Recreation
    Poultry Production
    Sheep Production
    Small Animal Production and Care
    Specialty Animal Production
    Specialty Crop Production
    Swine Production
    Turf Grass Management
    Vegetable Production
    Veterinary Science
    Wildlife Management
    Do not currently have an SAE program.
    I have a non-ag SAE program.
    I am not in FFA, but do have a job.


  1. Which leadership activities would you like to participate in this year?*
    Greenhand Conference (first-year HS members only)
    Chapman Leadership Conference (8th grade & freshmen only)
    Leader Lab (state-wide conference open to all HS students)
    WLC (national conference in summer 2013 - sophomores and juniors only)
    District Officer Candidate
    State Officer Candidate
    None


  1. Do you own an FFA Jacket? Mark all that apply.*
    Yes
    No
    I plan to purchase one this year.


  1. Would you like to apply for a district proficiency award?*
    Yes, this year.
    Yes, next year.
    No
    I would like more information.


  1. Briefly describe your SAE program? Include all areas with specific information relating to whether each area is entrepreneurship, placement, as well as other relevant information.


  1. What career development events have you participated in up to this point in your FFA career?*
    Ag Communications
    Ag Mechanics
    Greenhand Ag Mechanics (freshmen only)
    Ag Sales
    Agronomy
    Dairy Cattle Evaluation
    Dairy Foods
    Farm Business Management
    Floriculture
    Creed Speaking
    Extemporaneous Public Speaking
    Food Science
    Horse Evaluation
    Livestock Evaluation
    Meats Evaluation
    Nursery/Landscape
    Job Interview
    Prepared Public Speaking
    Parliamentary Procedure
    Poultry Evaluation
    Entomology
    Land/Homesite Evaluation
    Ag/Wildlife Identification (8th grade only)
    Veterinary Science
    None
    Not in FFA


  1. What career development events do you plan to participate in this school year?*
    Ag Communications
    Ag Mechanics
    Greenhand Ag Mechanics (freshmen only)
    Ag Sales
    Agronomy
    Dairy Cattle Evaluation
    Dairy Foods
    Farm Business Management
    Floriculture
    Creed Speaking
    Extemporaneous Public Speaking
    Food Science
    Horse Evaluation
    Livestock Evaluation
    Meats Evaluation
    Nursery/Landscape
    Job Interview
    Prepared Public Speaking
    Parliamentary Procedure
    Poultry Evaluation
    Entomology
    Land/Homesite Evaluation
    Ag/Wildlife Identification (8th grade only)
    Veterinary Science
    None
    Not in FFA


  1. What national FFA activities have you participated in up to this point in your FFA career?*
    National Convention
    National FFA Week activities
    National Band/Chorus
    Washington Leadership Conference
    SAE related national livestock show/competitions
    None
    Not in FFA


  1. What state FFA activities have you participated in up to this point in your FFA career?*
    State FFA Convention
    State Band/Chorus
    State Delegate
    State Conference for Chapter Leaders
    Leader Lab
    State Career Development Events
    SAE related state livestock show/competitions
    KS Beef Expo
    None
    Not in FFA


  1. What district FFA activities have you participated in up to this point in your FFA career?*
    District Banquet
    District Delegate
    Greenhand Conference
    Chapman Leadership Conference
    Proficiency Award Application
    District Officer Candidate
    None


  1. What local FFA activites have you participated in up to this point in your FFA career?*
    Chapter Banquet
    Fruit/Meat/Cookie/Seasoning Sales
    Popcorn/concession Sales
    FFA community service projects
    Fun nights
    State officer workshops
    Willie and the Beanstalk Soybean Competition
    Chapter meetings
    Committee meetings
    Work Auction
    Welcome Back BBQ
    None
    Not in FFA


  1. Since you became an FFA member (in high school if never in FFA) what is your estimate on how many community service hours you have logged? Include all FFA and non-FFA activities.*


  1. What are some new chapter activities that you would like to see our chapter implement in the 2012-13 school year?*





Mr. Kilgore
Agriculture Instructor
Blue Valley High School
Randolph, KS