4-H Club Parent Interest Survey
Parents are very important to the success of our 4-H club. In addition to the support and
encouragement you give to your own child, each of you has special skills and talents that can benefit the
whole group. We would like to involve you in ways that best fit your interests and schedules. Please
help us by completing this survey. A club leader will contact you to schedule your participation.
4-H Member’s Name: __________________________________________________________________
Name of Parent/Guardian: ______________________________________________________________
Phone Number: ________________________ Email: _______________________________________
I prefer to be contacted by: ____Email
_____ Phone (best time to reach: __________________)
In what way(s) could you help our 4-H club? Please check all possibilities.
_____ Teach a project. What type of subject matter? _________________________________________
_____ Teach a Cloverbud activity.
_____ Coordinate our club members’ participation in a county 4-H activity.
_____ Assist with a club community service project.
_____ Help members (one or more) prepare a talk or demonstration.
_____ Assist with fundraising.
_____ Chaperone or provide transportation to one or more 4-H activities.
_____ Provide general assistance at one or more club or project meetings.
_____ Provide refreshments for one or more club meetings.
What personal interests, hobbies, or career-related information would you be willing to share with 4-H
members?
_____________________________________________________________________________________
_____________________________________________________________________________________
(over)
4-H projects are divided into several topic areas. Please select the topics below in which you have the
greatest interest:
_____ Animal Science
_____ Community Involvement and Global Awareness
(Beef, Cat, Dairy, Dog, Goat, Horse & Pony, Poultry,
Rabbit, Sheep, Small Pets, Swine, Veterinary Science)
_____ Dairy
(Citizenship, Intercultural, Service Learning)
_____ Engineering and Technology
(Dairy Cattle, Dairy Goats)
(Aerospace, Bicycle, Computer Science, Electricity,
Geospatial, Robotics, Safety, Small Engines, Tractor,
Video/Filmmaking, Welding, Wind Power,
Woodworking)
_____ Environment and Natural Resources
_____ Food, Nutrition, and Health
(Camping & Outdoor Living, Entomology, Forestry,
Geology, Natural Resources, Shooting Sports,
Sportsfishing, Wildlife)
_____ Home and Family
(Foods & Nutrition, Physical and Mental Health)
_____ Personal Development
(Child Development, Consumer Education,
Entrepreneurship, Intergenerational, Interior Design,
Sewing & Textiles)
_____ Plants and Soils
(Communication, Leadership, Photography, Theater
Arts, Visual Arts)
_____ General/Overall 4-H Achievement
(Crops, Floriculture, Horticulture, Plant & Soil
Science)
(Record Keeping, Awards, Fair, Community Service)
When are you most available to help?
Season:
Day:
 Summer
Monday
Fall
Tuesday
 Winter
Wednesday
 Spring
Thursday
Friday
Saturday Sunday
Time:
Morning
Afternoon
Evening
Thank you for your participation in our club. We hope that your family will enjoy the 4-H program!