2. a. Parent/Caregiver Posttest OMB Control # 0584-0524
04/30/2013
OMB BURDEN STATEMENT: According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0584-0524. The time to complete this information collection is estimated to average 15 minutes per person, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.
Parent/Caregiver Survey
The Great Garden Detective Adventure
Posttest
2011
Confidentiality Statement:
We would like you to complete this survey. You may skip questions you do not want to answer but we hope that you will answer all of them.
You may complete the survey in pencil or pen.
The survey will take you no more than 15 minutes to complete.
Do not put your name, or your child’s name, anywhere on the survey. Any information about who you are will be kept private.
Please remove the packet of seeds before returning to your child’s teacher.
Please return the survey to your child’s teacher (teacher name) by (date).
Parent/Caregiver Posttest Survey
The Great Garden Detective Adventure
Dear Parent/Caregiver,
We would like to know your opinions about The Great Garden Detective Adventure nutrition education program taught in your child’s 3rd or 4th grade classroom. Please complete this survey and return it with your child to his or her teacher by (date). Keep the packet of seeds. It is our way of saying thank you for completing this survey.
Directions: Please answer each question as it applies to you.
1. Which school does your child attend? Check () one.
School Name
School Name
School Name
2. What grade is your child who brought this questionnaire home? Check () one.
3rd 4th
3. Is this child a boy or girl. Check () one. Boy Girl
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Part 1: Gardening. |
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Directions: For each question, check () one answer. |
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Very interested |
Somewhat interested |
Not interested |
1. At the beginning of the school year, how interested was your child in gardening? |
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2. Now, how interested is your child in gardening? |
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Part 2: Eating Fruits or Vegetables. |
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Directions: For each question, check () one answer. |
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Almost Always |
Sometimes |
Rarely |
Never |
1. At the beginning of the school year, how often did your child eat fruits? |
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2. Now, how often does your child eat fruits? |
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3. At the beginning of the school year, how often did your child eat vegetables? |
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4. Now, how often does your child eat vegetables? |
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5. At home, how often are these true for you? |
Almost Always |
Sometimes |
Rarely |
Never |
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Part 3: The Great Garden Detective Adventure Newsletters. |
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Directions: For each question, check () one answer. |
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8. Did you read this NEWSLETTER? |
Yes |
No |
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9. Did you do the ACTIVITIES in this NEWSLETTER with your child? |
Yes |
No |
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10. Did you do prepare the RECIPE with your child? |
Yes |
No |
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For each question, check () one answer. |
Yes |
No |
11. Did you submit a family recipe to be included in the class cookbook? |
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For each question, check () one answer. |
Strongly Agree |
Agree |
Disagree |
Strongly Disagree |
I don’t know |
12. The newsletters were very useful. |
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13. The newsletters were very interesting. |
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Thank you for completing this
survey!
File Type | application/msword |
Author | Susan Russell |
Last Modified By | Susan |
File Modified | 2011-06-08 |
File Created | 2011-06-08 |