Virginia Cooperative Extension – Floyd County Survey
The Floyd County Extension office would like to ask for your help. We want to hear from the people of Floyd, and all the folks that attend our programs. We want to know the programs and or information you are interested in learning more about.  Completion of the attached survey will help guide us in the programs for the near future.  


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Contact Information
Name
Email Address
Mailing Address
Phone Number
Preferred method of contact:
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If you are not already, would you like to be added to our VCE-Floyd Email list?  
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Are you active on social media (Facebook, Instagram)?        
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Areas of Interest:
Family Consumer Sciences
Agriculture & Natural Resources
Youth Development / 4-H
Program Participant Self-Reporting Form
Virginia Cooperative Extension asks that you voluntarily respond to the questions below. The cumulative demographic information is requested solely for the purpose of determining compliance with federal civil rights law, and your response will not affect your eligibility to participate in Extension programs. By providing this information, you will assist us in assuring that VCE programs are administered in a nondiscriminatory manner. Race/Ethnicity definitions are listed below.
Your Gender
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Your Age
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Race/Ethnicity definitions are listed below.
• American Indian or Alaskan Native: A person having origins in any of the original peoples of North America, south America, including Central America, and who maintains cultural identification through tribal affirmations or community recognition.
• Asian: A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam
• Black or African American: A person having origins in any of the black racial groups of Africa.
• Hispanic or Latino: A person of Mexican, Puerto Rican, Cuban, Central or South American or other Spanish culture or origin, regardless of race.
• Native Hawaiian or Other Pacific Islander: A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands.
• White: A person having origins in any of the original peoples of Europe, North Africa, or the Middle East.

Your Ethnicity
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Your Race
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 Virginia Cooperative Extension – Floyd County  https://www.facebook.com/VCEFloyd                                                                Virginia Cooperative Extension programs and employment are open to all, regardless of age, color, disability, gender, gender identity, gender expression, national origin, political affiliation, race, religion, sexual orientation, genetic information, veteran status, or any other basis protected by law. An equal opportunity/affirmative action employer. Issued in furtherance of Cooperative Extension work, Virginia Polytechnic Institute and State University, Virginia State University, and the U.S. Department of Agriculture cooperating. Edwin J. Jones, Director, Virginia Cooperative Extension, Virginia Tech, Blacksburg; M. Ray McKinnie, Administrator, 1890 Extension Program, Virginia State University, Petersburg.
Thank you for completing our survey!  Have a nice day.
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