Registration/Pre-survey - 2022 Virtual Dinner Tonight Healthy Cooking School - South Plains District
Welcome! We are excited that you have chosen to join us as we complete our FREE Virtual Dinner Tonight Healthy Cooking School. Several counties in the South Plains District are working together to bring you this awesome program. It will be offered FREE through our private Facebook group (link provided after you submit this form) from May 30 through August 21. We hope you will enjoy learning throughout the series and will interact with our posts.

Please complete the following registration form and pre-survey.
Sign in to Google to save your progress. Learn more
Name *
Email address *
County you reside in *
How did you find out about the program? *
Is this your first program to participate in through Texas A&M AgriLife Extension Service? *
Race/Ethnicity (please select one) *
What do you hope to learn from participating in this virtual program? *
Would you say in general your health is... *
During the past month, other than your regular job, did you participate in any moderate or vigorous intensity physical activities or exercises.  [MODERATE INTENSITY: You can talk, but not sing- walking briskly, water aerobics, bicycling slowly, tennis (doubles), general dancing, general gardening.   VIGOROUS INTENSITY: You're unable to say more than a few words without pausing for a breath- race walking, jogging, running, swimming laps, aerobic dancing, tennis (singles), fast bicycling, hiking uphill, heavy gardening (continuous digging or hoeing).] *
If yes, how many times per week did you take part in these activities during the past month?
When you took part in these activities, for how many minutes did you usually keep at it?
Generally speaking, how much of your lunch and dinner plates are filled with fruits and vegetables? *
How many times a day do you eat FRUIT? Examples of fruits are apples, bananas, oranges, grapes, raisins, melon, and berries. Include fresh, frozen, dried, or canned fruit. Do not include juice. *
How many times a day do you eat VEGETABLES? Examples of vegetables are green salad, corn, green beans, carrots, potatoes, greens, and squash. Include fresh, canned and frozen vegetables. Do not count French fries, potato chips or rice. *
How often do you drink regular sodas (not diet)? *
How often do you drink fruit punch, fruit drinks, sweet tea or sports drinks? *
For the next six questions choose your level of understanding of...
1 - poor; 2 - fair; 3 - good; 4 - excellent
How meal planning can help save time and reduce stress... *
Poor
Excellent
The sodium (salt) content of the foods you prepare... *
Poor
Excellent
The fat content of the foods you prepare... *
Poor
Excellent
The calorie content of the foods you prepare... *
Poor
Excellent
How the foods you eat impact your health... *
Poor
Excellent
How food safety impacts our meal and family... *
Poor
Excellent
For the next eight questions, please choose which best describes your level of confidence...
1 - no confidence; 2 - low confidence; 3 - moderate confidence; 4 - high confidence
Meal planning to prepare healthy meals... *
None
High
Modifying recipes to reduce calorie content... *
None
High
Modifying recipes to reduce sodium content... *
None
High
Modifying recipes to change or reduce fat content... *
None
High
Selecting quality produce (fruits & vegetables) at the grocery store or farmer's market... *
Poor
High
Safely storing fresh meats... *
None
High
Safely preparing fruits, vegetables, and meats... *
None
High
Ability to prepare food at home... *
None
High
What is your biggest struggle when planning meals? *
What is your biggest challenge in preparing meals for your family? (select all that apply) *
Required
Currently, about how many meals (breakfast, lunch, or dinner) do you or your family eat away from home (restaurants, fast food, etc…) each week? Do not include meals your child eats at school. *
What is the total amount spent each week on all the meals listed in question 15? Do not include money spent on meals your child eats at school. *
How many people live in your household? *
Thank you for taking time to complete this registration form and pre-survey. Once you hit submit, the link to our Facebook group will be there for you to join.
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms