eval report cover.indd - New Jersey Farm to School Network Wiki

National Farm to School Web Survey (Page 1 of 6)1. Introduction to the Request for InformationThank you for filling out this request for information. We anticipate this form will take 15 to 20 minutes to complete.The National Farm to School Program is conducting a survey of farm to school programs across the country. We areasking school food service staff and /or administrators to respond to this survey.If you oversee food service operations for the entire school district, please answer questions based on dataavailable for the school district. If you oversee operations for a single school, please provide data from your school.The information you provide will help develop a national clearing house of farm to school project information that willpromote successful farm to school models to more school districts across the country. The information will helpinform policy makers, legislators, funding agencies, media and other school districts about the scope and importanceof the farm to school program, which in turn will provide more credibility, support and resources for your efforts atthe local level.The information will be compiled and reported at the national level, and your individual responses will not be used orreported without your prior consent.2. School District Data/ General1. Please provide the following information.Your State:Name of your schooldistrict:If you are notrepresenting a schooldistrict, indicate the nameand type of yourindividual school (i.e.Alternative Schools orPreschools).2. Please indicate the student enrollment number of each type of school within yourschool district or for your individual school. PLEASE PROVIDE TOTAL IF BREAKDOWNBY SCHOOLS IS NOT EASILY AVAILABLE.DISTRICT TOTAL (If youfill this in, you do NOTneed to fill out the rest)ElementaryMiddle / Junior HighHighOther schools (i.e.Alternative Schools /Preschools)Farm Conclusions to School and Sample RecommendationsTools and Resources3. Please indicate the percentage of student enrollment participation in the Free orReduced Lunch Program (check one) PLEASE PROVIDE DISTRICT TOTAL IFBREAKDOWN BY SCHOOLS IS NOT EASILY AVAILABLE. If you are just answering foran individual school, check one category AFTER 'OTHER SCHOOLS.'0-25 % 26-50 % 51-75 % 76-100 %District Total (If you fillnmlkj nmlkj nmlkj nmlkjthis in, you do NOT needto fill out the rest)Elementary nmlkj nmlkj nmlkj nmlkjMiddle / Junior High nmlkj nmlkj nmlkj nmlkjHigh nmlkj nmlkj nmlkj nmlkjOther schools (i.e.Alternative Schools/Preschools)nmlkj nmlkj nmlkj nmlkj4. Please check whether you are filling out this survey for an individual school or anentire school district.nmlkjIndividual Schoolnmlkj School Districtwww.farmtoschool.org 109