Your help is needed in providing important feedback on the activities you have just completed. This information is important because your answers will serve as a guide for making changes to improve this activity. Please take a moment to complete this survey by telling us what skills you have gained as a result of your experience. Thank you for your support of this activity and the Texas 4-H and Youth Development Program.
How have your abilities and habits changed as a result of these activities? Please rate yourself by marking the appropriate response. Fill in the circle to mark your response. Example: F M
Never1 / Seldom
2 / Sometimes
3 / Often
4 / Always
5
Activity Impact
1) As a result of my involvement in this activity, my ability to: / BEFORE
4-H PULSE / AFTER
4-H PULSE
a. / identify important youth issues in my community has / / / / / / / / / /
b. / develop solutions to youth issues in my community has / / / / / / / / / /
c. / identify who in my community addresses these issues has / / / / / / / / / /
d. / link issues with solutions, and how to effect change has / / / / / / / / / /
e. / present myself to others positively has / / / / / / / / / /
f. / communicate effectively and interact with others has / / / / / / / / / /
g. / show confidence in myself has / / / / / / / / / /
h. / comfortably speak in front of a group has / / / / / / / / / /
i. / identify personality types of others has / / / / / / / / / /
j. / set goals for myself to achieve has / / / / / / / / / /
k. / identify solutions to problems has / / / / / / / / / /
l. / make good, informed decisions has / / / / / / / / / /
m. / learn from service I provide to my community has / / / / / / / / / /
n. / be an organized person has / / / / / / / / / /
o. / explore career interests on my own has / / / / / / / / / /
p. / make ethical choices has / / / / / / / / / /
q. / get involved in serving the community has / / / / / / / / / /
r. / identify local policies and laws that affect me has / / / / / / / / / /
s. / find needs in the community that I can help with has / / / / / / / / / /
t. / get involved in local issues has / / / / / / / / / /
u. / take steps to change things in my community has / / / / / / / / / /
v. / get involved with local decision-making groups has / / / / / / / / / /
w. / confidently express my interests with community leaders has / / / / / / / / / /
x. / get involved in my community has / / / / / / / / / /
Overall Impact
2) As a result of my involvement in this activity, my ability to: / BEFORE
4-H PULSE / AFTER
4-H PULSE
a. / identifying new issues and trends affecting youth has / / / / / / / / / /
b. / present myself in a positive manner has / / / / / / / / / /
c. / be a leader has / / / / / / / / / /
d. / serve the community has / / / / / / / / / /
e. / be confident and involve myself in the local decision-making process has / / / / / / / / / /
Activity Satisfaction
3) How satisfied were you with the following: / Not at all / Slightly / Somewhat / Mostly / Completely
a. / information being new to you / F / F / F / F / F
b. / information being easy to understand / F / F / F / F / F
c. / variety of topics / F / F / F / F / F
d. / completeness of information on each topic / F / F / F / F / F
e. / knowledge level of the presenter / F / F / F / F / F
f. / relevance of this information to me / F / F / F / F / F
Comments and Suggestions
If you rated any items as ANot at all@ or ASlightly@, please tell us why. If you have any other comments, please write them here.
Please tell us about yourself
4) / You are: F Female F Male / 10) / I consider myself to be:
F American Indian
F Asian
F Black
F White
5) / Your age:
6) / Your grade:
7) / Ever participated in 4-H PULSE before? F Yes F No
8) / Where do you attend school?
F Home school F Private F Public / 11) / Most of the time I live:
F Farm or ranch
F Town less than 10,000
F City between 10,000 - 50,000
F Suburb of city more than 50,000
F Central city more than 50,000
9) / I consider myself Hispanic: F Yes F No
THANK YOU for completing this evaluation!