Member Application
Name
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Address
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Phone Number
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Email
Your answer
Name of Parent or Guardian
Your answer
Age (as of January 1, 2018)
Your answer
Grade (as of January 1, 2018)
Your answer
Club
Please check which trip or award you are applying for:
Required
Please check any of the following trips that you have attended or awards you have received:
Required
Explain what being a 4-H member means to you.
Your answer
Identify why you want to attend the trip you are applying for.
Your answer
List the projects you are enrolled in and how many years you have been enrolled in the project.
Your answer
4-H Leadership
Share your leadership roles and accomplishments in relation to 4-H. Please be concise.
Your answer
Describe a leadership or teaching responsibility that you have had. Be sure to state the project or activity and what you have learned or how the experience has impacted you.
Your answer
Other 4-H Activities Summary
List additional 4-H participation that is not reported elsewhere in this application (examples: Creative Arts Day, Project Discovery Day, etc.). Be sure to include the role of your participation and be concise.
Your answer
Non 4-H Activities
List additional activities that you are involved in outside of 4-H. Be sure to include the role of your participation and be concise.
Your answer
Submit
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