Family, Career and Community Leaders of America Survey

Thank you in advance for completing this brief survey.  Your answers will allow us to form a VTHS Chapter of FCCLA that will be meaningful to both you and the National Organization.

First Name   

Last Name                 

Phone Number       973-555-1212                    

Grade                 

Home Room Teacher                 

Would you be interested in an Officer position in the FCCLA?

  Yes

  No

What Family and Consumer Science courses have you taken or are currently enrolled in? For multiple classes, hold down the control key to select more than one choice.

  Choose all that apply Fashion Construction I Ad. Fashion Const. II Fashion Construction III Fashion Major Interior Design Fabric Crafts Parenting to Pre-School Basic Foods International Foods American Cuisine Gourmet Foods Culinary Chef Advanced Culinary Arts  

Check the days of the week you are available for meetings.

Tuesday

Wednesday

Thursday

Choose the mode of transportation you will use most often for FCCLA after school meetings and activities.

  choose one drive myself parent pick up bus transportation provided by school

Write 3-5 sentences explaining your hobbies, interests, and future career goals.

What FCCLA programs are of interest to you?  Hold down the control key to select more than one choice.

  Choose all that apply Career Connection Community Service Dynamic Leadership FACTS Families First Financial Fitness Japanese Exchange Leaders at Work Power of One STAR Events STOP the Violence Student Body

Would you be interested in serving as a student/faculty liaison? 

Yes

No

Thank you for filling out the FCCLA survey.  Your involvement in FCCLA will prove to strengthen your leadership skills, broaden community involvement, and advance career opportunities.