EARTH HOUR PATCH PROGRAM ONLINE SURVEY
RequiredRequired Question(s)

Please complete and submit this online survey by April 10, 2012 to receive your collectable glow- in-the-dark patch!  Please complete one survey per troop or family. Girls under 14, please complete with a parent or guardian!

 

 
Required 1.

Name:

 

 

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Required 2.

Troop #:

 

 

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Required 3.

Email Address (parent or troop leader):

 

 

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Required 4.

Number of girls participating:

 

 

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Required 5.

Girl Scout Level (for multi-level troops, please select all that apply):

 

Dasiy
Brownie
Junior
Cadette
Senior
Ambassador
Required 6.

Local Service Center:

 

Antelope Valley/Lancaster
Arcadia
Long Beach
Marina del Rey
Montclair
Santa Clarita
Woodland Hills
Required 7.

What did you discover about energy and energy conservation?

 

 

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Required 8.

Who did you connect with? How and when did you connect with them? What was their response?

 

 

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Required 9.

What did you do to conserve energy?

 

 

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Required 10.

Which Discover item did you complete?

 

Discover your carbon footprint
Find the difference between a renewable and a non-renewable energy source
Find the different ways your city, town, or county supports energy conservation
Find out how much trash the average household produces daily. How much of that is recyclable
Where does our recycled trash go? What does it become
Required 11.

Which Connect item did you complete?

 

Contact your local government representative and tell them that you're a Girl Scout who cares about energy conservation
Connect with local Departments of Water and Power and ask them about their Sustainability Plan
Get a local school, church, or business to participate in Earth Hour, and to promote it to the public
Visit your local recycling center and learn about all the different materials they recycle
Learn what "E-waste" is, and find out where it can be recycled in your neighborhood
Required 12.

Which Take Action item did you complete?

 

Have an "Earth Hour" campout in your backyard
Have a candlelight picnic with friends or family
Check for drafts in your house. Make your own draft stopper and install it
The Five-minute shower challenge
Visit your local hardware store and learn about simple ways to conserve energy
Required 13.

Had you heard of "Earth Hour" before this program?

 

Yes
No
Required 14.

Would you like to participate again next year?

 

Yes
No
Required 15.

What other kinds of "eco-action" are important to you? (Please choose as many as you want.)

 

Reducing Waste
Saving Water
Planting Trees
Electricity Conservation
Protecting Endangered Species
Other  
Required 16.

What else can you do to help the earth?

 

 

1000 characters left.