Wisconsin Agriculture in the Classroom

Activity Impact Report Form

Wisconsin Agriculture in the Classroom tracks information on agricultural literacy activities- including impact, budget, volunteers and other tactical information, to share collective, state-wide program reach with program sponsors, as well as plan future trainings and resources for county programs.

Complete a new form for each event/or montly report (which ever fits your program best.)

At the end of the Fiscal Year (September 30th) a report of the total submitted activities for a county will be emailed to each respective county Agriculture in the Classroom Coordinator and County President.

This information can then be easily plugged into the County Agriculture in the Classroom Year-End Report.

Please reach out to Beth Schaefer, bschaefer@wfbf.com, 608-577-6845, with any questions.

County Agriculture in the Classroom Information

Select Farm Bureau County/Name: *

Person Submitting Form (First and Last Name) *

Email *

Phone Number *

Agriculture in the Classroom Impact

Please answer the questions to the best of you knowledge and memory.

Name of Activity/Event *

Activity Start Date * +

Activity End Date * +

Select Type of Agriculture in the Classroom Activity: *

State Staff - Select Type of Agriculture in the Classroom Activity: *

How many teachers did you impact in-person and for how long? Please write the number of teachers for each length of workshop or contact time. For example, if you spent .5 hours with 4 teachers talking about the essay contest, you should include a "4" in the 0-.5 hours category.

	Elementary	Middle	High School
.5 - 2 hours	Elementary	Middle	High School
2-3 hours	Elementary	Middle	High School
4-5 hours	Elementary	Middle	High School
6-8 hours	Elementary	Middle	High School
9+ hours	Elementary	Middle	High School

How many pre-service teachers did you impact in-person and for how long? Please write the number of teachers for each length of workshop or contact time. For example, if you spent .5 hours with 4 teachers talking about the essay contest, you should include a "4" in the 0-.5 hours category.

	Elementary	Middle	High School
.5 - 2 hours	Elementary	Middle	High School
2-3 hours	Elementary	Middle	High School
4-5 hours	Elementary	Middle	High School
6-8 hours	Elementary	Middle	High School
9+ hours	Elementary	Middle	High School

How many teachers did you impact virtually and for how long? Please write the number of teachers for each length of workshop or contact time. For example, if you spent .5 hours with 4 elementary teachers talking about the essay contest, you should include a "4" in the 0-.5 hours "Elementary" column.

	Elementary	Middle	High School
.5 - 2 hours	Elementary	Middle	High School
2-3 hours	Elementary	Middle	High School
4-5 hours	Elementary	Middle	High School
6-8 hours	Elementary	Middle	High School
9+ hours	Elementary	Middle	High School

How many volunteers/members did you impact in-person and for how long? Please write the number for each length of contact time. For example, if you spent .5 hours with 4 volunteers talking about the essay contest, you should include a "4" in the 0-.5 hours column.

	Volunteers/Members
.5 - 2 hours	Volunteers/Members
2-3 hours	Volunteers/Members
4-5 hours	Volunteers/Members
6-8 hours	Volunteers/Members
9+ hours	Volunteers/Members

How many volunteers/members did you impact virtually and for how long? Please write the number for each length of contact time. For example, if you spent .5 hours with 4 volunteers talking about the essay contest, you should include a "4" in the 0-.5 hours column.

	Volunteers/Members
.5 - 2 hours	Volunteers/Members
2-3 hours	Volunteers/Members
4-5 hours	Volunteers/Members
6-8 hours	Volunteers/Members
9+ hours	Volunteers/Members

How many pre-service teachers did you impact virtually and for how long? Please write the number of teachers for each length of workshop or contact time. For example, if you spent .5 hours with 4 elementary teachers talking about the essay contest, you should include a "4" in the 0-.5 hours "Elementary" column.

	Elementary	Middle	High School
.5 - 2 hours	Elementary	Middle	High School
2-3 hours	Elementary	Middle	High School
4-5 hours	Elementary	Middle	High School
6-8 hours	Elementary	Middle	High School
9+ hours	Elementary	Middle	High School

How many students did you impact in-person and for how long? Please write the number of teachers for each length of workshop or contact time. For example, if you spent 1 hour with 30 elementary students, you should include a "30" in the 0-.5 hours "Elementary" column.

	Elementary	Middle	High School
.5 - 2 hours	Elementary	Middle	High School
2-3 hours	Elementary	Middle	High School
4-5 hours	Elementary	Middle	High School
6-8 hours	Elementary	Middle	High School
9+ hours	Elementary	Middle	High School

How many students did you impact virtually and for how long? Please write the number of teachers for each length of workshop or contact time. For example, if you spent 1 hour with 30 elementary students, you should include a "30" in the 0-.5 hours "Elementary" column.

	Elementary	Middle	High School
.5 - 1 hours	Elementary	Middle	High School
2-3 hours	Elementary	Middle	High School
4-5 hours	Elementary	Middle	High School
6-8 hours	Elementary	Middle	High School
9+ hours	Elementary	Middle	High School

Did you provide materials from WI Ag in the Classroom? Examples include books, ag mags, Business Called Agriculture/Exploring Wisconsin Agriculture, AgBadging Field Guides *

Yes

No

List the number of schools and students who received these resources.

	Number of Students	Number of Teachers
Lower Elementary (Grades PK-2)	Number of Students	Number of Teachers
Upper Elementary (Grades 3-5)	Number of Students	Number of Teachers
Middle (Grades 6-8)	Number of Students	Number of Teachers
High School (Grades 9-12)	Number of Students	Number of Teachers

How many volunteers (including committee members) supported the activity and for how long? Include numbers from planning, set-up, event, and tear-down/event recap meetings.

	Planning/Pre-Event # of Volunteers	Day(s) of Event # of Volunteers	Post-Event # of Volunteers
>2 hours	Planning/Pre-Event # of Volunteers	Day(s) of Event # of Volunteers	Post-Event # of Volunteers
3-5 hours	Planning/Pre-Event # of Volunteers	Day(s) of Event # of Volunteers	Post-Event # of Volunteers
6-8 hours	Planning/Pre-Event # of Volunteers	Day(s) of Event # of Volunteers	Post-Event # of Volunteers
9-11 hours	Planning/Pre-Event # of Volunteers	Day(s) of Event # of Volunteers	Post-Event # of Volunteers
11-15 hours	Planning/Pre-Event # of Volunteers	Day(s) of Event # of Volunteers	Post-Event # of Volunteers
15-20 hours	Planning/Pre-Event # of Volunteers	Day(s) of Event # of Volunteers	Post-Event # of Volunteers
20+ hours	Planning/Pre-Event # of Volunteers	Day(s) of Event # of Volunteers	Post-Event # of Volunteers

List any other organizations that partnered to deliver THIS Agriculture in the Classroom activity.

+-

Upload up to five images. (Not required)

Please include this activity for the County All Star Awards.

Yes! Remind us to apply for the County All Star Awards.

Please share any additional details or learnings from this activity/event. *