Wisconsin FFA Alumni Association
Agriculture Instructor Recognition Program
The agriculture instructor will be recognized at the Wisconsin FFA Alumni Convention if the instructor earns a
minimum of 100 points on this form. The applications need to be postmarked by November 30th. (Complete
the questions for the time period of December 1st – November 30th)
Instructor’s Name: __________________________________________
Affiliate: ______________________
School mailing address: ______________________________________________________________________
Name of principal: ___________________________________________
1. Did the instructor attend local FFA Alumni business meetings? (40 points maximum)
____________% of meetings attended x 40 points = _____________
(Example: 50% of meetings x 40 points = 20 points earned)
Please circle the appropriate answer below the question.
2. Is the instructor an FFA Alumni member?
i. Annual (5 points)
Lifetime (15 points)
3. Did the instructor attend the spring and/or fall sectional FFA Alumni meetings?
1. Spring (10 points)
Fall (10 points)
points)
4. Did the instructor attend the Wisconsin FFA Alumni Convention?
i. Yes (25 points)
Neither (0
No (0 points)
5. Did the FFA Chapter apply for a Local Program Support Grant from the national
FFA Alumni Association?
i. Yes (10 points)
No (0 points)
6. Did any FFA members apply for a Washington Leadership Conference Scholarship?
i. Yes (10 points)
No (0 points)
7. Did the instructor attend the Alumni Development Conference?
i. Yes (20 points)
No (0 points)
8. Did the instructor encourage parents of current FFA members to join the FFA Alumni?
i. Yes (10 points)
No (0 points)
9. Did the FFA Chapter allow the FFA Alumni to give greetings at the Chapter FFA Banquet?
i. Yes (5 points)
No (0 points)
10. Is the FFA Alumni included in FFA Week publicity?
i. Yes (5 points)
No (0 points)
11. List up to five other ways that the instructor has helped promote or assist the FFA Alumni. (5 points for
each item listed)
a. ______________________________________________________________________________
b. ______________________________________________________________________________
c. ______________________________________________________________________________
d. ______________________________________________________________________________
e. ______________________________________________________________________________
Total Points Earned: ___________
__________________________________________________________
(FFA Alumni President’s Signature)
____________
(Date)
Please return to: Wisconsin FFA Alumni Association, N29452 Brekke Ridge Road, Blair, WI 54616