DUE: JUNE 20, 2014

AG CONFERENCE SERVICES, 430 Student Union

ROUNDUP ADULT REGISTRATION FORM

One form must be completed for each adult attending Roundup!

District County Gender

Name Work Phone

Educator Certified Volunteer Intern Cell #

Email Address

List area of interest (for assignments)

If you are in charge or have been asked to assist with an event or activity, please list below: Event/Activity/Etc.

Dates and Times

For individuals with disabilities who require auxiliary aids or services for program participation, please identify the accommodation/service needed when submitting this form. Advance notice is necessary for effective service provision; it may not be possible to provide some aids and services with late notice. Reasonable effort will be made to accommodate individuals who request auxiliary aids or services.

EACH ADULT WILL BE ASSIGNED TO ASSIST WITH ROUNDUP ACTIVITIES.

Please rank top three choices per day (except Friday).

L:Roundup\Forms/Supradlt.doc revised 3/99

*** Rank top three choices per day***

WEDNESDAY CHOICES

Rank / Chair P / Title
Assist with Spotlights and AV at Assembly
Assist with Seating By District at Assembly
Asst. with Technology (facebook, twitter, trivia, etc).)
Communication Contest
FCS Skill-a-thon
Job Readiness Evaluation
Vocal Contest
Educational Workshops
Assist with Buses for Workshops (help youth and adults load)
Picnic (crowd control/monitor trash/etc.)
Group Picture Assistance
Dance
Other Evening Entertainment
Pizza Distribution

THURSDAY CHOICES

Assist with Spotlights and AV at Assembly
Assist with Seating By District at Assembly
Asst. with Technology (facebook, twitter, trivia, etc).)
Tractor Workshop and Contest
Land Judging Contest
Job Readiness Interviews and/or Workshop
Livestock Quiz Bowl
Clover Quiz Bowl
Food Showdown
Educational Workshops
Assist with Buses for Workshops (help youth and adults load)
Driver (MUST provide bus to workshops,/contests)
Rehearsal for 4-H Has Talent (includes assisting with event on Friday)
Rehearsal for Honor Assembly
Asst. with Honor Night Seating Prior to and during Assembly
Honor Night Assembly
Dance
Other Evening Entertainment
Assist with Voting
Pizza Distribution

FRIDAY CHOICES

Assist with Spotlights and AV at Assembly
Assist with Seating By District at Assembly
Asst. with Technology (facebook, twitter, trivia, etc.)
4-H Has Talent (includes rehearsal on Thursday afternoon)

(for office use only)

Wednesday: Event: ______Location: ______Time: ______

Thursday: Event: ______Location: ______Time: ______

Friday: Event: ______Location: ______Time: ______


2014 Oklahoma 4-H Roundup

Place Bonding

Participants Information Sheet

To: Roundup Youth Delegate, Adult Volunteer, and Extension Educators

We are inviting you to take short survey about your experience on the OSU campus. Please read this letter and ask any questions you may have before taking this survey.

The study: This study will help find out if coming to 4-H events, such as Roundup, affect the way you feel about the OSU campus. You will be asked to complete an online survey either on your phone or computer. The survey will take about 10 minutes to complete. You may take the survey at any time between the last morning at Roundup and the following Monday, July 28th at 8:00 in the morning. Please only take this survey once.

Risks and benefits: There are no known risks in taking this survey. There are also no direct benefits from taking this survey.

Participation is voluntary: You do not have to participate even if your parents gave your permission. There is no penalty for not taking the survey and you are free to quit at any time. Your decision to fill out the survey or not to fill it out will not change your relationship with Oklahoma State University or with your school or 4-H club. If you decide to take part, you are free to skip any questions, or stop at any time.

Confidentiality: Your answers will be kept private. Anything written about this study will only discuss group results. Your answers will be kept safe and only researchers and those supervising them will be able to see the records. Note that Qualtrics (state online service to be used) has specific privacy policies of their own. You should be aware that this web service may be able to link your responses to your ID in ways that are not bound by this consent form and the data confidentiality procedures used in this study, and if you have concerns you should consult this service directly. Qualtrics’ privacy statement is provided at: http://qualtrics.com/privacy-statement.

Contacts : Stephen Beck Kevin Fink

205 4-H Youth Development 301 Scott Hall

Stillwater, OK 74078 Stillwater, OK 74078

If you have questions about your rights as a research volunteer, you may contact Dr. Shelia Kennison, IRB Chair, 219 Cordell North, Stillwater, OK 74078, 405-744-3377 or .

Steve Beck Kevin Fink

Oklahoma 4-H/Youth Development Nutritional Sciences

Oklahoma State University Oklahoma State University