Samples

This page contains sample data collection forms, needs surveys and DFRYSC PowerPoint presentations. Users may modify sample forms and surveys to meet center needs. 

The forms and spreadsheets below are SAMPLES created by FRYSC Coordinators and are placed here with permission. 

• FRYSC Balance Sheet for individual line items
• Purchase Orders Spreadsheet
• Blank P. O. Worksheet
• Training-Event Follow-up Form
• Permission to Participate Form
• Log No. 1 (Word)
• Log No. 2 (Word)
• Log No. 3 Excel
• Log Report Coversheet
• Student Referral Form
• Large Group Activity Form
• JCPS Programs-Services (Excel)
• Inventory Log

Parent Surveys

• Region 4 Sample Needs Assessment Letter
• Region 4 Sample Needs Assessment
• Region 6 FRC Parent Survey
• Region 6 FRYSC Parent Survey
• Region 6 YSC Parent Survey
• Little Lakers FRC Parent Survey
• FRC Parent Survey North_Pointe Elementary School
• Jessamine Parent Survey
• Lincoln FRC Parent Survey
• Lincoln Parent Form
• Region 1 FRC Parent Form
• Region 1 YSC Parent Form
• Shelby FRC Parent Survey

Student Surveys

• Jessamine Student Survey
• Lincoln Student Survey
• Madison MMS Student Survey
• Madison MCHS Student Survey
• Region 1 Student Survey
• Region 4 MS Student Survey

Faculty Surveys

• Jessamine Faculty Survey
• Region 1 Faculty Survey

The evaluation tools below are FRYSC-specific evaluations developed by school districts.  You may use and modify these forms to meet your district needs.

• Pike County Coordinator Evaluation Tool
  
• Mercer County Schools Coordinator Evaluation
  
• Covington Independent Coordinator Evaluation
  
• Madison County FRYSC Coordinator Evaluation Form
  
• FRYSC Coordinator Performance Evaluation and accompanying FRYSC Coordinator Job Description (developed by Region 1 FRYSC staff)