Cultural Arts & Heritage Program of Work Report
From July 1, 2011 to June 30, 2012
Name of person completing this form: ______Phone: ______Email: ______
For clubs reports: (Club reports are due to the County Cultural Arts Chairman by July 1, 2012.)
Club Name: ______
For county reports: (County reports are due to the Area Cultural Arts Chairman by August 15, 2012.)
County: ______Number of Clubs reporting: ______
For area reports: (Area reports are due to the KEHA Cultural Arts Chairman by September 15, 2012. Please mail to Kitty Davis, 2501 Irvin Cobb Road, Murray, Ky, 42071.)
Area: ______Number of Counties reporting: ______
:
1. Did your club/county use the Book List? ____ yes ___ no
If yes, how many books were read? ______
2. List crafts taught during this reporting year.
3. List any Cultural Arts trips taken. Indicate if the trips were for the club or county.
4. How many quilts did your club/county make this year? ______
5. Please share information regarding sales of crafts learned through KEHA lessons, camps, and other activities
Items sold for personal profit created $______in total income.
Items sold for program funding generated $______in revenue.
List programs funded and amounts designated to each (i.e. scholarships, community project, etc.)
6. Number of barn quilt squares made and installed in your community this year ______
Appendix 21
June 2011
Environment, Housing and Energy Program of Work Report
From July 1, 2011 to June 30, 2012
Name of person completing this form: ______Phone: ______Email: ______
For clubs reports: (Club reports are due to the County Environment, Housing and Energy Chairman by July 1, 2012.)
Club Name: ______
For county reports: (County reports are due to the Area Environment, Housing and Energy Chairman by August 15, 2012.)
County: ______Number of Clubs reporting: ______
For area reports: (Area reports are due to the KEHA Environment, Housing and Energy Chairman by September 15, 2012. Mail to Elizabeth Adams, 122 Lancaster Street, Crab Orchard, KY 40419.)
Area: ______Number of Counties reporting: ______
Environment, Housing & Energy
1. List environmental observances/activities in which the club/county participated with a brief description of your participation.
(ex. Earth Day - presented a recycling program at a local school for __ students; Adopt-A-Highway – cleaned __ miles of roadside each month; etc.)
2. Number of members who took actions related to environment, housing and energy listed below:
a. Used landscaping to aid in energy conservation ____
b. Used water saving practices ____
c. Participated in the 40 Gallon Challenge water conservation campaign: _____
d. Participated with the Reward Yourself Energy Saving Calendar: _____
Approx. $$ saved: ______
e. Recycled regularly _____
Appendix 22
June 2011
4-H Youth Development Program of Work Report
From July 1, 2011 to June 30, 2012
Name of person completing this form: ______Phone: ______Email: ______
For clubs reports: (Club reports are due to the County 4-H Youth Development Chairman by July 1, 2012.)
Club Name: ______
For county reports: (County reports are due to the Area 4-H Youth Development Chairman by August 15, 2012.)
County: ______Number of Clubs reporting: ______
For area reports: (Area reports are due to the KEHA 4-H Youth Development Chairman by September 15, 2012. Mail to Harlene Welch, 1730 Pedro Pike, KY 41031.)
Area: ______Number of Counties reporting: ______
The following questions apply to all youth, not just those in 4-H Youth Development programs.
· Number of members who worked with youth during past year.______
· Total number of volunteer hours acquired through youth development work.______
· Number of 4-H Camp scholarships/sponsorships given by your club.______
· Number of youth that attended 4-H camp because of these scholarships/sponsorships._____
· Total number of youth reached.______
What did you do with youth (teaching, mentoring, judging project, etc)?
4-H Lessons/Activities Taught: (check all that apply)
___ Hand Quilting ___ Machine Quilting ___ Hand Stitches
___ Quilting Word Search ___ Driving Tour- Community Barn Quilt Squares
___ Quilting Challenge—”Make a Pillowcase and Make a Difference”
What Charity or organization received a pillowcase(s)?
How many pillowcases were made and donated?
What have you as a Homemaker put into practice in your life as a result of these lessons?
Appendix 23
June 2011
Family and Individual Development Program of Work Report
From July 1, 2011 to June 30, 2012
Name of person completing this form: ______Phone: ______Email: ______
For clubs reports: (Club reports are due to the County Family & Individual Development Chairman by July 1, 2012.)
Club Name: ______
For county reports: (County reports are due to the Area Family & Individual Development Chairman by August 15, 2012.)
County: ______Number of Clubs reporting: ______
For area reports: (Area reports are due to the KEHA Family & Individual Development Chairman by September 15, 2012. Please mail to: Ruth Dietsch, 4853 St Rt 1820, Cunningham, KY 42035.)
Area: ______Number of Counties reporting: ______
Number who:
a. Held a program which demonstrated support to military families
______Club _____Homemakers
Description of Activity:
b. Practiced or had a guest speaker on flag etiquette
______Club _____Homemakers
Description of Activity:
c. Held an event(s) to demonstrate support/recognition to those raising grandchildren
_____Club _____Homemakers
Description of Activity:
d. Held a workshop addressing the new electronic devices and media for grandparents/relatives raising grandchildren
_____Club _____Homemakers
Description of Activity:
e. Made a lifestyle change to acknowledge its impact on healthy lifestyle
_____Club _____Homemakers
Description of Activity:
f. Had an assessment to determine their risk for cardiovascular disease
_____Club _____Homemakers
g. Attend or participated in a Matter of Balance-Fear of Falling workshop
_____Club _____Homemakers
Appendix 24
June 2011
Food, Nutrition and Health Program of Work Report
From July 1, 2011 to June 30, 2012
Name of person completing this form: ______Phone: ______Email: ______
For clubs reports: (Club reports are due to the County Food, Nutrition and Health Chairman by July 1, 2012.)
Club Name: ______
For county reports: (County reports are due to the Area Food, Nutrition and Health Chairman by August 15, 2012.)
County: ______Number of Clubs reporting: ______
For area reports: (Area reports are due to the KEHA Food, Nutrition and Health Chairman by September 15, 2012. Mail to Julie Hook, 74 County Road 1021, Cunningham, KY 42035.)
Area: ______Number of Counties reporting: ______
Food, Nutrition and Health
1. Number of members who:
a. Had an annual physical / check-up ____
b. Had a Mammogram _____
c. Had an Ovarian Cancer Screening ____
d. Had a Diabetes Screening ____
e. Exercised regularly (20-30 minutes at least 3 times a week) ____
f. Changed their diet to improve health ___
2. Number of members who participated in:
a. Kentucky Women’s Health Registry ____
b. Second Sunday ____
c. One or more local blood drives ____
d. One or more local health fairs ____
3. Food security:
a. Number of members who donated to a local food bank or food pantry ______
b. Number of members who volunteered time at a local food bank or food pantry ______
c. Number who donated to a “backpack for hunger” program ______
d. Number who volunteered time with a “backpack for hunger” program ______
e. Number of children served by a local “backpack for hunger” program ______
4. Did your club/county host an Ovarian Cancer Awareness Tea Party for ovarian cancer awareness and fundraising? If yes, how many attended: ______. How much money was raised? ______
5. If you would like, please share 1 or 2 special health programs you are doing.
Appendix 25
June 2011
International Program of Work Report
From July 1, 2011 to June 30, 2012
Name of person completing this form: ______Phone: ______Email: ______
For clubs reports: (Club reports are due to the County International Chairman by July 1, 2012.)
Club Name: ______
For county reports: (County reports are due to the Area International Chairman by August 15, 2012.)
County: ______Number of Clubs reporting: ______
For area reports: (Area reports are due to the KEHA International Chairman by September 15, 2012. Please mail to Cathy Kunkel-Mains, 13127 Madison Pike, Morning View, KY 41063.)
Area: ______Number of Counties reporting: ______
International
1. Did you use the presentations and resources on the KEHA website to share International lessons?
a. Empowering Women: Women’s Access to Credit ___ Number reached: ______
b. Empowering Women: Financial Management ___ Number reached: ______
2. How many members attended the ACWW Network meeting at the KEHA State Meeting in May 2011? ______
3. Number of members who participated in a special club project for International ______
4. Number of members who participated in a county International Program ______
5. Number of members who participated in the KEHA state-level International Project ______
6. Number of members who hosted an exchange student or adult ______
7. Number of members who participated in Homemaker Letter Exchange Friends ______
Appendix 26
June 2011
Leadership Development Program of Work Report
From July 1, 2011 to June 30, 2012
Name of person completing this form: ______Phone: ______Email: ______
For clubs reports: (Club reports are due to the County Leadership Development Chairman by July 1, 2012.)
Club Name: ______
For county reports: (County reports are due to the Area Leadership Development Chairman by August 15, 2012.)
County: ______Number of Clubs reporting: ______
For area reports: (Area reports are due to the KEHA Leadership Development Chairman by September 15, 2012. Mail to Faye Privett, 104 Eagle Bend Drive, Sadieville, KY 40370.)
Area: ______Number of Counties reporting: ______
1. Trainings conducted and participation: (Check those that apply and provide participation numbers.)
a. Club officer and chairman training ____ Number trained: ______
b. County officer and chairman training ____ Number trained: ______
c. Area officer and chairman training ____ Number trained: ______
2. Provide examples of how members have used their training to serve other community groups.
3. Extension volunteerism:
a. Number of members volunteering for Extension activities and events: ______
b. Total hours volunteered: ______Total number of people reached: ______
4. Community volunteerism: (non-Extension activities and events)
a. Number of members volunteering for community activities and events: ______
b. Total hours volunteered: ______Total number of people reached: ______
5. Educational scholarships awarded. (Please do not include 4-H Camp scholarships in this section. Report those numbers and amounts in the 4-H Youth Development section.)
a. Club scholarships – How many? _____ Total amount given: $______
b. County scholarships – How many? _____ Total amount given: $______
c. Area scholarships – How many? _____ Total amount given: $______
6. How many members increased their knowledge of the public policy/governmental process? ______
7. On the back of this page, please describe one community service or engagement activity that is a source of pride for your club. Include the impact of the activity.
Appendix 27
June 2011
Management and Safety Program of Work Report
From July 1, 2011 to June 30, 2012
Name of person completing this form: ______Phone: ______Email: ______
For clubs reports: (Club reports are due to the County Management and Safety Chairman by July 1, 2012.)
Club Name: ______
For county reports: (County reports are due to the Area Management and Safety Chairman by August 15, 2012.)
County: ______Number of Clubs reporting: ______
For area reports: (Area reports are due to the KEHA Management and Safety Chairman by September 15, 2012. Mail to Elaine Chenoweth, 434 Lick Branch Road, Glasgow, KY 42141.)
Area: ______Number of Counties reporting: ______
1. Number of members completing Matter of Balance series ______
2. How many Matter of Balance facilitators have been trained in your county? ______
3. Number of members submitting entries for the “There Ought to be a Law” contest ______
4. How many members participated in a farm or home safety day or program? ______
5. How many members utilized fall prevention techniques to prevent injury? ______
6. How many members participated in a financial awareness workshop? ______
7. How many members used Extension resources in making financial decisions? ______
8. How many members have reduced family food expenditures through coupon use? ______What is the estimated amount saved per week? ______
Appendix 28
June 2011