Butte Falls bulletin., July 01, 1995, Image 13

IW IO B S
B U T T E F A L L S H A S R E C E N T L Y R E C E IV E D A G R A N T O F $ 5 ,0 0 0 . F R O M T H E JA C K S O N
C O U N T Y C O M M IS S IO N O N C H IL D R E N A N D F A M IL IE S . W IT H T H IS M O N E Y B U T T E F A L L S IS
T O E S T A B L IS H A P R E N A T A L P R O G R A M A D D R E S S IN G A G E S 0 -6 , P R E V E N T A T IV E H E A L T H
C A R E IS S U E S , A N D P A R E N T IN G .
$ $ $ Y O U C A N H E L P U S S P E N D O U R D O L L A R S W IS E L Y ! $ $ $
P L E A S E C O M P L E T E T H E F O L L O W IN G S U R V E Y A N D R E T U R N B Y JU L Y 15
1. D O Y O U H A V E C H IL D R E N 0 -6 L IV IN G IN Y O U R H O M E ? IF S O P L E A S E C IR C L E T H E IR
AGES.
HOW M ANY?
. 0
1
JIHGFEDCBA
2
4
3
5 FEDCBA
6
2 . IN W H A T A G E C A T E G O R Y IS T H E P E R S O N C O M P L E T IN G T H IS F O R M ?
1 7 -2 0
2 1 -2 5
2 6 -3 5
3 6 -4 5
4 6 -5 4
55+
M ALE
FEM A LE
3 . W H A T A R E Y O U R N E E D S ? W H A T A C T IV IT IE S W O U L D B E N E F IT Y O U R F A M IL Y ?
M T E IN
NT
PAREN
G O C R L P
A R S O
S E G S R A M S
— H EA LTH Y BA BY CLASSED
C R IS IS C H IL D C A R E
P R E -S C H O O L A C T IV IT IE S
CPR
— A FTER SCHOOL PRO GRA M
M O T H E R -T O -B E C L A S S E S
F O R K IN D E R G A R T E N E R S
R E S O U R C E IN F O R M A T IO N
— N U T R IT IO N
IM M U N IZ A T IO N S
P R E -S C H O O L E R
TODDLER
BABY
HOW TO CARE FOR YOUR:
4 . W O U L D Y O U U S E A F A M IL Y C E N T E R T H A T P R O V ID E D M A N Y O F T H E A B O V E
PROGRAM S?
YES
NO
5 . IF Y O U H A D A W IS H L IS T A N D C O U L D C R E A T E F IV E P R O G R A M S F O R T H E C E N T E R W H A T
W O U LD TH EY BE?
6 . W O U L D Y O U A T T E N D A M E E T IN G T O H E L P P L A N T H E C E N T E R ? Y E S
NO
T H A N K Y O U F O R T A K IN G T H E T IM E T O C O M P L E T E T H IS F O R M .
PLEASE RETURN FORM TO ADDRESS ON BACK, OR DROP OFF AT THE B.F. LIBRARY.
F O L D F O R M A N D T A P E O R S T A P L E B E F O R E M A IL IN G