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FY586Elder Companion Overview1Elizabeth B. Bolton21.This document is FCS5246/FY586, one of a series of the Departme nt of Family, Youth and Community Sciences, University of Flor ida, UF/IFAS, Gainesville 32611. First published: September 1999. Revised: January 2004. Reviewed by: Mary Chernesky M.S. extension agent IV HillsboroughCounty, Seffner; Audrey Norman, courtesy extension agent, Palm Beach County, West Palm Beach; Meredith Taylor, M.S., extension agent IV,Suwannee County, Live Oak. Please visit the EDIS Web site:.http://edis.ifas.ufl.edu/ 2.Elizabeth B. Bolton, Ph.D., professor, Community Development, Department of Family, Youth and Community Sciences, Florida Coo perative Extension Service, University of Florid a, UF/IFAS, Gainesville, 32611. The Institute of Food and Agricultural Sc iences is an equal opportunity/affirmative action employer authorized to provide resea rch, educational information and other services only to individuals and inst itutions that function without regard to race color, sex, age, handicap, or national origin. For information on obtaining other extension publications, contact your count y Cooperative Extension Servic e office. Florida Cooperative Extension Service / Instit ute of Food and Agricultural Sciences / Un iversity of Florida / Christine Taylor Waddill, Dean.
Overview Pg. 3Elder Companion Training Program The Elder Companion training program is designed to train persons interested in becoming employed by local service providers as sitter/companions for the elderly. The objective of the program is to help participants develop the necessary skills to provide high-quality care including: assistance with daily living activities, home management services and companionship for the elderly adult. This training course is preparatory to studying to become a certified nursing assistant (CNA). The following topics are addressed:Roles and Responsibilities of CompanionsSensitivity to AgingCommunicationNutrition and Food ManagementHome MaintenanceStress ManagementTime ManagementLeisure ActivitiesGetting a Job as an Elder Companion In addition to the above topics which are taught as lessons 1 through 9 in a classroom setting, participants will be required to make a field observation at an elder care facility. An Agents guide and observation form are provided in Attachment 1. Assumptions about the Elder Companion Training 1.The Elder Companion Curriculum is designed to serve as a training guide for use by Extension county faculty or other professionals with expertise in the subject or content and type of learning activities to be used. 2.The design of the training should be individualized to meet the needs of the local job market for elder sitters/companions. 3.Training can be delivered in an approximate time frame of 35-40 hours with a minimum of 5 hours being a field observation at an elder care facility. Teaching/learning activities include short lectures, group discussions, demonstrations, skills practices, role playing, written exercises and hands-on experiences for work with the elderly.
Overview Pg. 44.The Elder Companion Training will be used to train people for employment by service providers/agencies. The initial cost of liability insurance and bonding make self-employment prohibitive for most participants. 5.If the service provider/agency that employs the Elder Companion is required to provide a privacy practices notification in compliance with the Health Insurance Portability Act (HIPAA), it is their responsibility to send the notice to the client. 6.All participants will be required to sign the form releasing the University of Florida of any liability. 7.Participants who complete a minimum of 30 hours of class time and the field observation will receive a completion certificate from the agency providing the training. Program Planning and Implementation Guide 1.Contact your area/local agency on aging. They can provide information on the employers in your area. 2.Assemble a group of people who will be hiring people as elder companions. Involve them in identification of: requirements for employment; training needs; and job availability. 3.The following curriculum is available at the EDIS website: http://edis.ifas.ufl.edu/TOPIC_Family_and Consumer Issues Role/Responsibility of a Companion Sensitivity to Aging Communication Skills Time and Stress Management Managing Nutritional Needs Home Maintenance Using Leisure Time Getting a Job As An Elder Companion 4.Compare local needs and requirements with what Cooperative Extension or other agencies are prepared to offer. Using this information, develop a plan of action. 5.Determine how potential trainees will be identified. Will they be screened for interest in working with the elderly? Will they do background checks?
Overview Pg. 56.Determine the dates, location and persons who will be involved with the training (i.e. instructors, resource persons). Confirm any outside instructors who will take part in the training. Identify the locations for clients to do their field observations and confirm dates and times. 7.Duplicate any materials needed for the training. Handouts should be provided for each participant. These are a part of each lesson and are designed to be used as overheads. Some of the handouts are EDIS publications and are available from the following website: http://edis.ifas.ufl.edu/TOPIC_Family_and Consumer Issues 8.Conduct the training. 9.Give Pre-tests before each lesson and Post-tests after each lesson to determine how much knowledge each participant absorbed. (See Attachment 2.) 10.After the training, issue certificates to individuals who complete the training. It will be necessary to keep an attendance record for each participant to insure that they complied with the completion requirements. (See Attachment 3.) 11.At the final session, have clients evaluate the training program. Evaluation forms are provided in Attachment 4. Selection Process Considerations Background Screening Many of the companion/sitter jobs being advertised require background screening, drug testing and clearance by the Florida Abuse Registry under the Department of Children and Families. When taking a position with a service provider and/or agency, the background check and abuse registry requirements must be met within five days of the person going to work. There is a nominal fee for the background check. The state no longer registers individuals as companions/sitters so there are no requirements in place for people who are operating as private contractors. It would seem reasonable that part of the screening process should be to eliminate people who are known to be drug users, or who have criminal or physically/mentally abusive backgrounds. This elimination process will avoid raising false hopes for obtaining employment. Some of the local providers for the job training are going to require the background checks as a prerequisite to participation in the training. Other sites will allow anyone to be trained and require the background checks as a condition of employment. Issuing a letter along with the completion certificate will serve as a reference for future employment. The letter will state that the background checks, drug use and abuse register clearance are the responsibility of the employer. A sample of this letter follows for your use and/or adaptation.
Overview Pg. 6Sample Letter to Prospective Employers Dear_______________________: Attached you will find a list of persons who have successfully completed the 35-hour Elder Companion Class. The content of the training included: sensitivity to aging, communication, nutrition, home maintenance and safety, time and stress management, and leisure activities for elderly clients. They have received their certificate of completion as of (date). Also enclosed is a copy of their resumes, to familiarize you with their experience and background. These graduates are trained caregivers whom you may choose to recommend as you receive requests for someone with these skills. We encourage you to suggest that your clients follow through with screening procedures by checking references, completing a background check, etc., since this is not a pre-requisite for our class. If you have any questions, feel free to contact me at (____) _____________. Sincerely, _____________________________ Program Instructor
Overview Pg. 7Desirable Skills Many of the jobs being advertised require the following skills/resources as a condition for employment: Ability to Read:The newspaper, the mail, directions on prescription bottles, preparation instructions for food, use of cleaning supplies. Valid Drivers License:To drive the elderly client to doctor appointments and/or the store. Reliable Transportation:To get to work and arrive on time. With the exception of Ability to Read these are not requirements to participate in the training but they would make the person more employable. Desire to Be Elder Companion Working as an elder companion/sitter is not suitable employment for every individual. Even though there is an increasing need, placing the wrong person in a position with elderly clients could create a potentially harmful situation. It is highly desirable that only participants who are interested or have some experience in this type of employment be trained as Elder Companions. Suggested Program Outline This is a suggested outline for the Elder Companion program. It can be adjusted as needed. Time frames allocated will depend on the size of the class. You and your community resource person or other collaborator will determine the amount of time during any given day that the clients can attend training. It may only be possible for a half day and not for an entire 8 hour day. DAY ONE Roles and Responsibilities Aging DAY TWO Communication Nutrition DAY THREE Home Maintenance and Safety Stress Management Time Management DAY FOUR Leisure Activities Getting a Job DAY FIVE Field Observation
Overview Pg. 8Suggested Daily Schedule DAY ONE TimeContentResource Person(s) 8:30 9:45Welcome Registration Get-acquainted Overview & Objectives Agreement County Faculty 9:45 10:30 Introduction to the Job County Faculty 10:30 10:45 Break 10:45 12:00 noonIntroduction to the Job (continues) Clients Rights Roles and Responsibilities Personal Appearance Personal Qualities Ethics Dos and Donts Emergency Situations Daily Activity Log County Faculty and person from hiring agency 12:00 noon 1:00Lunch 1:00 3:00 Aging Who are the Elderly? Facts about Older Americans County Faculty; person from Area Local Agency on Aging 3:00 3:15 Break 3:15 4:30 Aging (continues) Physical Changes of the Elderly Elder Abuse County Faculty; person from Area Local Agency on Aging
Overview Pg. 9Suggested Daily Schedule DAY TWO TimeContentResource Person(s) 8:30 10:30Communication with the Elderly Communication Process Basic Human Needs Self-Awareness Sending A Message County Faculty 10:30 10:45 Break 10:45 12:00 noonCommunication (continues) Active Listening Physical and Emotional Blocks to Communication County Faculty 12:00 noon 1:00Lunch 1:00 3:15 Managing Nutrition Nutritional Health Food Guide Pyramid Are My Hands Clean? How to Measure Food Safety Guidelines County Faculty; local dietitian
Overview Pg. 10Suggested Daily Schedule DAY THREE TimeContentResource Person(s) 8:30 10:30Home Maintenance and Safety What is Clean? Keeping the Clients Home Clean Organizing for Cleanliness County Faculty 10:30 10:45Break 10:45 12:00 noonHome Maintenance (continues) Managing the Laundry Sanitation Procedures Safety Agreement with Client County Faculty and person who works doing home maintenance 12:00 noon 1:00Lunch 1:00 3:00Stress Management Stress... What is Yours? Warning Signs of Stress Job Stress for the Elder Companion Strategies to Deal with Stressors County Faculty, Psychologist, Mental Health Professional 3:00 3:15Break 3:15 4:30Time Management How do I Spend My Time? Prime Time Making Better Use if My Time County Faculty
Overview Pg. 11Suggested Daily Schedule DAY FOUR TimeContentResource Person(s) 8:30 10:30Leisure Activities Purposes of Leisure Activity for the Elderly Possible Activities for My Client County Faculty and/or Recreation Staff Member 10:30 10:45Break 10:45 12:00 noon Leisure Time Exercises Simple Exercises to Use with Clients Exercise Physiologist 12:00 noon 1:00Lunch 1:00 3:00Obtaining Employment Things I Like About Me What Do Employers Look For? Resume Writing and Application Completion Getting Letters of Reference County Faculty and employer of Elder Companions 3:00 3:15Break 3:15 4:30The Interview Process Preparing for the Interview The Job Interview Contract for the Elder Companion County Faculty or Human Resources Director
Overview Pg. 12 Elder Companion Training Outcomes a nd Student Performance Standards Required Section (25 hours) Assist in the Care of the ElderlyBehavioral Outcome Activities Handouts Describe the role of the companion in providing care and assistance to an elderly person. View clips from Driving Miss Daisy video. (Available at most video rental stores.) Make a list of the roles preformed by a companion Roles and Responsibilities of the Elder Companion Guidelines for Personal Appearance Personal Qualities Ethics Client Rights Describe the physical, social, emotional and mental changes that may take place in aging. Sensory Exercises Physical Changes of the Elderly and Ways to Help Describe the special needs of the elderly. Sensory Exercises Physical Changes of the Elderly and Ways to Help Identify own feelings toward the elderly. Case Study Describe problems of clients with decreased mobility, decreased vision or hearing, decreased tactile acuity, low energy, and confusion. Sensory Exercises Describe symptoms of abuse and neglect. Exercise: Abuse and Neglect of the Elderly Emergency Reporting Review the laws in reporting abuse or neglect of an elderly person.
Overview Pg. 13 Training Outcomes and Student Performance Standards (continued) Apply Effective Human Relationships and InteractionsBehavioral Outcome Activities Handouts State four physical needs that all humans share. Human Need ScenariosBasic Human Needs State three psychological needs that all humans share. Describe how individuals and families differ. Case Study Describe the need for dignity and circumstances which contribute to loss of self-esteem in elderly. Case Study Demonstrate how emotional control affects human interactions and changing relationships and/or communication. Case Study Explain what is meant by communication, and what is verbal and non-verbal communication. Exercise: Self-Awareness and Communication Suggestions for Communicating Behaviors Which Interfere With Listening Demonstrate active listening skills. Communication skills. Exercise: Receiving Messages Exercise: Stating and Listening to Differences Exercise: Active Listening Suggestions for Active Listening Demonstrate patience and techniques for working with other family members.
Overview Pg. 14 Training Outcomes and Student Performance Standards (continued) Assist Clients with Personal, Social, and Recreational Matters When Needed Behavioral Outcome Activities Handouts Explain the importance of family and friends as part of the support system. Explain the role of the companion in assisting a client with social and leisure activities such as reading, board games, music or other social and recreational activities. Possible Activities Identify accountability tools to show interaction with the clients... daily log/schedules. Daily Log Demonstrate Exercises for Older Adults. Role Playing of Exercises for Older Adults Exercises for Older Adults Describe clients need for privacy and confidentiality. Case Study
Overview Pg. 15 Training Outcomes and Student Performance Standards (continued) Assist in Maintaining a Safe and Sanitary Environment for Clients Behavioral OutcomeActivitiesHandoutsDemonstrate proper hand washing techniques. Hand washing exercise using black light. When to Wash? Demonstrate proper storage and preparation of hot and cold foods. Practice Demonstration Safety in the Kitchen Check Sheets on Kitchen Hazards Prevent Food Poisoning Food Safety and Storage Describe how the spread of disease is controlled in the home in relationship to kitchens, bathrooms, laundry, dusting and food handling. Demonstrate sanitation as it relates to laundry...if the person has an accident and soils themselves or bed, action has to be taken. What Is Clean? Tools to Do the Job Cleaning Agents to Do the Job How to Clean Organizing to Get the Work Done Household Tasks Rules of Organization House Cleaning Plan Weekly Plan for Household Cleaning Describe emergency response...numbers, directions to the house, fire extinguishers Role play emergency situationEmergency Reporting Identify safety measures necessary for maintaining a safe environment such as clear traffic areas or walkways, loose rugs, electricity and safety bars. View pictures and/or video which illustrate home hazards and identify them. Household Safety Checklist Safety for Older AdultsProvide Personal Care Services for ClientsExplain the difference between administering medication and assisting with medication. Role playing assistance with medication Dos and Donts
Overview Pg. 16 Training Outcomes and Student Performance Standards (continued) Demonstrate Stress ManagementBehavioral Outcome Activities Handouts Identify factors that create negative stress and explain how they affect behavior. (Needs to include alcohol.) Know Your Stressors Warning Signals of Stress Stress Diary Check for Behavior Warning Signals Describe methods of managing stress such as diets, leisure activities and exercise. Role play what can be done for stress management Steps to Manage Stress Handout on Exercise Handout on Leisure Activities Explain how problem-solving techniques help in stress management. Stressful Situations ScenariosStress for an Elder Companion
Overview Pg. 17 Training Outcomes and Student Performance Standards (continued) Demonstrate Employability Skills Behavioral Outcome Activities Handouts Look for a job. Things I Like About Me Secure information about a job; skills and training required by the job. Job Search Describe documents that may be required when applying for a job. Information needed to apply for a job. Resume Writing The Application Complete a job application form correctly. The Application Demonstrate competence in job interview techniques. (Dos and Donts in the interview.) Preparing for A Job InterviewQuestions You Can Ask Questions Not to Ask Identify acceptable work habits. (No Smoking.) What Do I Have to Offer Demonstrate acceptable employee health habits. Write a resume for this specific job. Resume Writing My Practice Resume Identify personal characteristics desired for working with people. What Are Employers Seeking?Top 20 Positive Characteristics Employers Are Seeking Participate in a Field Observation program with someone who is an Elder Companion (5 Hours)
Overview Pg. 18 OPTIONAL SECTIONS (7 hours is required in one of the following areas) Provide Basic Homemaker Services to Client and FamilyBehavioral Outcome Activities Handouts Identify a logical order for performing tasks to save time and energy. Organizing to Get the Job DoneHousekeeping TaskRules of Organization Household Cleaning Schedule Weekly Plan for Household Cleaning Demonstrate correct procedures for basic household cleaning tasks performed daily, weekly, monthly, and occasionally. What Is Clean? How to Clean How to Clean Demonstrate correct procedures for selection, use, care and storage of supplies and equipment. Tools to Do the Job Cleaning Agents to Do the Job Demonstrate correct procedures for laundry including stain removal. Managing the Laundry Eight Basic Steps to Clean Laundry
Overview Pg. 19 Training Outcomes and Student Performance Standards (continued) Develop Plans for Meeting Nutritiona l Needs of Clients and Families Behavioral Outcome Activities HandoutsEvaluate own diet for one week in relation to the Food Guide Pyramid Nutritional Health The Food Guide Pyramid What Did you Eat? Assistance with preparation and serving of foods or meals according to the Food Guide Pyramid considering clients cultural preferences and personal needs. When Do I Wash? Apply the principles of special diets that may be used in the plan for care of the client; i.e., measure food accurately by using correct procedures and equipment. How Do I Measure? Explain ways to assist a client with feeding without feeding the client. Dos and Donts Apply the principles of food safety and storage. Keeping Food Safe Smart Not SorryKeep Food Safety in Mind Prevent Food PoisoningAdapted by Extension Professionals attending Elder Companion Training, March, 1999. Original source: Florida Department of Education, Curriculum Framework, Elderly and Disabled Care Services, July 1998.
Overview Pg. 20Elder Companion Teaching Activities Roles and Responsibilities Overview of Training Roles and Responsibilities Dos and Donts for the Elder Companion Handling Emergencies Clients Rights Aging Who Are the Elderly? Physical Changes Elder Abuse Communication Basic Human Needs Self Awareness/Sending Messages Active Listening Nutrition Nutritional Health The Food Guide Pyramid How Do I Wash My Hands? How Do I Measure? Food Safety Home Maintenance and Safety What is Clean? Tools to Do the Job Cleaning Agents to Do the Job How to Clean Organizing to Get the Job Done Managing the Laundry General Home Safety Safety in the Kitchen Stress Management What Is Your Stress? Warning Signals of Stress Handling Stress Stress for the Elder Companion
Overview Pg. 21Time Management Time Analysis Prime Time Organizing Time Leisure Activities Why Engage in Leisure Activities? Leisure Activities for the Elderly Exercises for Older Adults Getting the Job Things I Like About Me What Are Employers Seeking? Job Search Resume Writing The Application Preparing for a Job Interview Interview Questions You Might Be Asked The Job Interview Sample Contract for the Elder Companion Field Observation Field Observation (5 hours) Debriefing the Observation
Overview Pg. 22Credits and Acknowledgments The Elder Companion Training curriculum was originally developed as a component of the UF/IFAS Welfare-to-Work Initiative (Grant #A6218) funded by the Florida Agency for Workforce Innovation (formerly Florida Department of Labor and Employmen t Security); Principal Investigator, Elizabeth B. Bolton, professor of Community Development, Department of Family, Youth and Community Sciences. The curriculum was developed by Linda D. Cook, former professor, University of Florida, Institute of Food and Agricultural Sciences, Family, Youth and Community Sciences, and revised for electronic publication by Elizabeth B. Bolton, professor of Community Development, University of Florida, Institute of Food and Agricultural Sciences, Department of Family, Youth and Community Sciences. Parts of the Elder Companion program were adapte d from the Home Care Companion program first developed by the Alabama Cooperative Extension Service, Auburn University, and the Senior Series developed by the Center for Rural Elderly and the University of Missouri.
Overview Pg. 23ATTACHMENTS
Overview Pg. 24Attachment 1 AGENT GUIDE Field Observation Time:5 hours...all at one time/or at various intervals in the training. Introduction: The best way to see what the job of Elder Companion will be like is to shadow someone for a period of time during their work day. We have arranged for each of you to make a field observation in the community. After your field observation, we will reconvene to discuss what you observed. DO: Review with the Elder Companion trainees the Field Observation Sheet.Discuss conduct which is appropriate for a field observation.Send trainees to their field observation. REFLECT:What was the Elder Companion/Sitter doing with the client while you were present?What was the relationship between the elderly person and the companion?Would you have done anything differently?What did the companion do well?What did you learn? APPLY: How will you use this in your work as an elder companion?
Overview Pg. 25Attachment 1 (continued) Field Observation Sheet Date of Field Observation: _____________________________________________________________ Location of Field Observation: __________________________________________________________ List of the Job Responsibilities Observed: Describe the elderly person being cared for: Describe the relationship between the elderly person and the companion: List things that you learned during the Field Observation: Identify any areas where you would have dealt with the situation differently: Name of Person Observed: _____________________________________________________________ Name of Person Doing the Observation: __________________________________________________
Overview Pg. 26Attachment 2 Name:_____________________ Date:______________________ Agent Fill In: Pre Test Post Test (circle one) KNOWLEDGE TEST Roles and Responsibilities TFA companion always knows what is best for the client. TFA companion may wear the same clothes two days in a row if the clothes dont look dirty. TFA companions shoes should not have open toes or high heels. TFIts always okay for a companion to wear perfume. TFWhen caring for elderly clients, you should encourage self-care and independence. In dealing with the clients medicines, a companion should NEVER : _____ (a) put pills in a clients mouth. _____ (b) hand the client a medicine bottle when asked. _____ (c) remind a client when to take a medicine. _____ (d) tell the person in charge if a client is not taking medicine. Name two responsibilities that a companion may have.
Overview Pg. 27Attachment 2 (continued) Name:_____________________ Date:______________________ Agent Fill In: Pre Test Post Test (circle one) KNOWLEDGE TEST Aging TFElderly people are all alike. TFChanges in hearing can affect a persons behavior. TFAs we age, our bones are more brittle and more likely to break. TFOlder people have some of the same basic human needs as do young people. Name three senses that aging affects. (a) (b) (c) Name two steps to take in an emergency situation. (a) (b)
Overview Pg. 28Attachment 2 (continued) Name:_____________________ Date:______________________ Agent Fill In: Pre Test Post Test (circle one) KNOWLEDGE TEST Communication TFFor good communication, it is important to listen well. To improve communication with persons who have a hearing problem, you can do which of the following? (Check as many as apply.) _____ (a) speak at a shout. _____ (b) speak clearly in a moderate voice. _____ (c) vary the loudness and tone of your voice. _____ (d) face the person directly. _____ (e) talk faster.
Overview Pg. 29Attachment 2 (continued) Name:_____________________ Date:______________________ Agent Fill In: Pre Test Post Test (circle one) KNOWLEDGE TEST Nutrition TFHand washing is very important in preventing the spread of disease. Older people may not eat well because: _____ (a) they cant afford the right food. _____ (b) they are physically unable to shop and prepare food. _____ (c) they don t like eating alone. _____ (d) all of the above. Name three occasions when the companion should wash her/his hands. (a) (b) (c) Name three of the five major food groups. (a) (b) (c)
Overview Pg. 30Attachment 2 (continued) Name:_____________________ Date:______________________ Agent Fill In: Pre Test Post Test (circle one) KNOWLEDGE TEST Home Maintenance TFKeeping a house clean means different things to different people. TFBaking soda is good for deodorizing the refrigerator. TFSorting is an important step in doing laundry.
Overview Pg. 31Attachment 2 (continued) Name:_____________________ Date:______________________ Agent Fill In: Pre Test Post Test (circle one) KNOWLEDGE TEST Stress/Time Management TFStress can be both good and bad. TFTime management helps you have more time. TFPrime time is when the soap operas are on. TFSleeplessness is a warning sign of stress.
Overview Pg. 32Attachment 2 (continued) Name:_____________________ Date:______________________ Agent Fill In: Pre Test Post Test (circle one) KNOWLEDGE TEST Leisure Activities TFConfused individuals are not able to enjoy recreational activities. TFElderly people can engage in physical activities. TFPhysical and leisure activities address the social needs of clients.
Overview Pg. 33 Attachment 3 RECORD OF ATTENDANCE NameDates
Overview Pg. 34Attachment 4 EVALUATION OF TRAINING Please complete the following to help us evaluate the Elder Companion Training. 1.Of the information presented and experiences offered, how helpful do you think each lesson will be to you? (Circle one for each lesson.) Roles and Responsibilities Very HelpfulHelpfulNot Helpful Aging Very HelpfulHelpfulNot Helpful Communication Very HelpfulHelpfulNot Helpful Nutrition Very HelpfulHelpfulNot Helpful Home Maintenance and Safety Very HelpfulHelpfulNot Helpful Stress Management Very HelpfulHelpfulNot Helpful Time Management Very HelpfulHelpfulNot Helpful Leisure Activities Very HelpfulHelpfulNot Helpful Getting a Job Very HelpfulHelpfulNot Helpful Field Observation Very HelpfulHelpfulNot Helpful
Overview Pg. 35Attachment 4 (continued) 2.How do you plan to use the information you learned? (Check all that apply.) _____as an elder companion employed for wages _____as a volunteer companion _____to care for family member or friend _____I probably wont use it _____other (please explain) _____________________________________________________ 3.How would you rate this program? Excellent ____ Very Good ____ Good ____ Fair ____ Poor ____ 4.What suggestions would you make for improving this program? (If you need more room, write on the back of this sheet.) 5.Have you ever attended an Extension activity before?_____Yes____No 6.Would you like to receive information about other Extension educational opportunities? ___Yes___No If yes, give address below. Additional Comments: ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ Name (optional): _____________________________________________________________________ Address: ____________________________________________________________________________