Washington FFA State Officer Visit Request Form
Prior to submitting your request, please read the Visit/Presentation Expectations and Information document. This document is available at www.washingtonffa.org/visit-request. District Sweep Schedule: September 23rd-27th-D1 ; October 7th-11th- D2; October 14th-18th- D3; October 28th-Nov 1- D5; November 4th-8th- D6; November 12th-15th- D8; November 18th-22nd- D9; December 2nd-6th- D7; December 9th-13th- D4
Chapter
*
District
*
Advisor
*
First Name
Last Name
Email
*
example@example.com
Phone
*
Please enter a valid phone number.
Address1
Address2
City
State
*
Zip
Back
Next
What is your school's policy for students from a different school visiting your campus? This is in the case of sub-district or district level events.
*
Visit Information
Indicate the type, date, and time of your requested visit.
Type of Visit
*
Virtual (conducted by video conference)
In-person
Do you need a multi-day visit due to split classrooms, schedules, or other circumstances?
*
Yes (Indicate which dates below)
No
PRIMARY Date for Visit
*
-
Month
-
Day
Year
Date
Event Start Time
*
Hour Minutes
AM
PM
AM/PM Option
Event EndTime
*
Hour Minutes
AM
PM
AM/PM Option
First Alternate Date for Visit
*
-
Month
-
Day
Year
Date
Second Alternate Date for Visit
*
-
Month
-
Day
Year
Date
Third Alternate Date for Visit
-
Month
-
Day
Year
Date
Back
Next
State Officer Preference (Dependent on officer availability)
*
Emily Ryder
Levi Kukes
Ashley Landt
Makenna Barron
Jordan Jelinek
Kassidy Wilfong
No Preference
First Choice
Second Choice
Third Choice
Type of Dress
*
Official Dress
BPro (Polo/Button up w/ Khakis)
Polo/Button Up w/ Jeans
Casual Dress
Other (please specify below)
Type of Visit/Presentation
*
Classroom/Small Group Facillitation/Chapter Meeting
Speech (Select for banquet requests)
Chapter/District Leadership Training
Sponsor Meeting/Business & Industry Tour
Other (please specify below)
Lunch/Meal Expectations
*
Lunch/Meals will be provided for the officer(s).
Officer(s) are responsible for their own meal(s). Options will be provided.
Virtual visit, no meal required.
Other (please specify below)
Is the advisor able to provide a homestay?
*
Yes
No
Other (please specify below)
Back
Next
Classroom/Small Group Facilitation/Chapter Meeting
Classroom equipment available (Check all that apply)
*
Combination Desks/Chairs
Lab Tables
Open Shop Area
Computer Lab
Projector/Screen with computer hookup
Smart Board
Dry Erase Board
Easel(s)
WiFi
Access to websites such as YouTube for video presentations
Other (please specify)
How many times will the State Officer(s) be presenting? (include number of classes/periods, number of students in each class/period/chapter, speeches, grade of students, etc.)
*
Please list all classes the officer(s) would be presenting in, and the normal attendance numbers. If you chose "Other" above, please describe the nature of the chapter visit.
Provide basic information about your chapter/students related to the visit request
*
Examples: "Mostly freshmen," "Would be learning about beef repro during the visit", "Will have two new teams preparing for district competition that would like feedback," "speaking to a group of 50 growers," etc.
Back
Next
Speech (Banquet visits included)
How long would you like the officer(s) to speak?
1-2 minutes (Short Greetings)
3-5 minutes (Long Greetings)
6-8 minutes (Short Keynote)
9-11 minutes (Medium Keynote)
12-15 minutes (Long Keynote)
Other (please specify)
What venue will the speech take place?
Cafeteria without stage
Cafeteria with stage
Gymnasium without stage
Gymnasium with stage
Auditorium
Other (please specify)
Estimated number of audience in attendance
AV Equipment Available (Check all that apply)
Wireless Handheld Microphone
Lapel/Lavalier/Body Microphone
Projector/Screen w/ computer connections
Connections for Sound from Phone/Computer
Other (please specify)
Back
Next
Chapter/District Leadership Visit
What venue will the speech take place?
*
Cafeteria without stage
Cafeteria with stage
Gymnasium without stage
Gymnasium with stage
Auditorium
Other (please specify)
Estimated number of audience in attendance
*
Facilitation equipment available (Check all that apply)
*
Tables/Chairs
Open Area for Activities
Writing Utensils/Paper
Computers/Laptops
Projector/Screen with computer connections
Smart Board
Dry Erase Board
Easel(s)
WiFI
Access to websites such as YouTube for video presentations
Other (please specify)
AV Equipment Available (Check all that apply)
*
Wireless Handheld Microphone
Lapel/Lavalier/Body Microphone
Projector/Screen w/ computer connections
Connections for Sound from Phone/Computer
Other (please specify)
Back
Next
Sponsor Meeting/Business and Industry Tour
What group/business/organization will the officer(s) be visiting?
What is the name/title/occupation of the main contact the officer(s) will be meeting?
Mailling Address of Main Contact
Does the group/business/organization currently support the Washington FFA Foundation?
Yes
No
Will the State Officer(s) be asked to give a presentation to members of the group/business/organization?
Yes
No
Safety Requirements for Tours (Check all that apply)
Personal ID (License)
Ear protection
Eye protection
Specific Footwear (Closed toe/heel, work boots, etc.)
Special Clothing (pants, disposable overalls, etc.)
Medical Release Forms/Liability Waivers/Non Disclosure Forms
No Photography
Parking Restrictions
Age Restrictions
Not Applicable
Other (please specify)
Back
Next
Additional Information/Special Notes
Other information important for the State Officer(s) to be aware. (Special guetss, building entrance instructions, audience members with special needs, help with award presentation, etc.). If you selected "Other" on "Type of Visit" please provide detailed information about the event to help the state officer(s) plan.
By signing below I acknowledge that I have read the State Officer Visit/Presentations Expectations document and agree to adhere to the requirements as outlined, including but not limited to homestay/accomodations, clarifying class expectations, and agreeing to be present for the entirety of the visit while officers are onsite. Failing to meet these expectations may result in cancellation of my requested visit.
*
Submit
Should be Empty: