URAP – Instrument Draft 7
Q 1. What is your gender?
o Male
o Female
Q 2. What is your age? _____
Q 3. What is the highest grade or year of school you completed?
o
o
o
o
o
o
o
Never attended school or only attended kindergarten
Grades 1 through 8 (Elementary)
Grades 9 through 11 (Some high school)
Grade 12 or GED (High school graduate)
College 1 year to 3 years (Some college or technical school)
College 4 years or more (College graduate)
Other
Q 4. What county do you live in? __________________
Q 5. What is your type of operation on your ranch or farm?
o
o
o
o
o
o
Individual
Partnership
Incorporated
Other
I don’t know
Refuse answer
Q 6. What is the size of your operation (in acres) on your ranch or farm?
o
o
o
o
o
o
o
o
o
1-9
10-49
50-179
180-499
500-999
1,000-1,999
2,000 or more
I don’t know
Refuse answer
Q 7. What type of commodity is produced at your ranch or farm? (Please check all that apply)
o
o
o
o
o
o
o
o
o
o
o
o
o
Beef cattle/calves
Dairy cattle/goat
Chicken eggs
Broilers
Greenhouse/nursery
Hay
Ryegrass
Wheat
Onions
Potatoes
Other (please specify) ______
I don’t know
Refuse answer
Q 8. How many of your employees that work on your ranch or farm are 18 years of age or older? (Please
specify)
___________ (number employees)
o I don’t know
o Refuse answer
Q 9. How many of your employees ages 18 and older operate ATVs on your ranch or farm? (Please specify)
___________ (number employees)
o I don’t know
o Refuse answer
Q 10. How many of your employees that work on your ranch or farm are ages 14-17 years old? (Please specify)
___________ (number employees)
o I don’t know
o Refuse answer
Q 11. How many of your employees ages 14-17 years old operate ATVs on your ranch or farm? (Please
specify)
___________ (number employees)
o I don’t know
o Refuse answer
Q 12. If employee’s ages 14-17 years old operate ATVs on your ranch or farm, what size of ATV are they
operating? (Please check all ATV sizes that employees in each age category use)
Age
Size of ATV
14
15
16
17
50cc-125cc




125cc-250cc




250cc-400cc




400cc-700cc




Greater than 700cc




I don’t know




Refuse answer




Q 13. In general, how many hours a day do 14-17 year olds use ATVs for work related purposes on your ranch
or farm?
o
o
o
o
o
o
o
o
o
o
o
Less than 1 hour
1 hour
2 hours
3 hours
4 hours
5 hours
6 hours
7 hours
8 hours
I don’t know
Refuse answer
Q 14. Are your employees ages 14-17 years old required to wear personal protective equipment?
o Yes
o No
GO TO QUESTION 15
GO TO QUESTION 16
Q 15. If so, what types of personal protective equipment are your employees ages 14-17 years old required to
wear? (For each type of personal protective equipment, please check yes or no)
Helmets
 Yes
 No
Gloves
 Yes
 No
Long sleeve shirts
 Yes
 No
Goggles
 Yes
 No
Long pants
 Yes
 No
Over the ankle boots
 Yes
 No
Q 16. What types of attachment(s)/accessories are used with ATVs by 14-17 year olds on your ranch or farm?
(Please check all that apply)
Plow
Spreader
Brush grubber
Disc
Gun carrier
Swivel dump/trailer
Front/rear baskets
Arena drags
Water trailer
Harrows
Trailer sprayer
Roller
Tiller
Mower
Aerator
Sweeper
Bagger
Spot sprayer
Rear blade
Three point hitch system
o Cultivator
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
Planter
o
o
o
o
o
o
o
o
Winch
Back hoe
Boom sprayer
Snow plow
Auger
Other (please specify) _________
I don’t know
Refuse answer
THANK YOU!!