Contra Costa County 4-H Event / Conference / Camp Reimbursement Request

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Contra Costa County 4-H Event Fee Support

Eligibility:
Open to current Contra Costa County 4-H members.

Amount Available:
Covers up to 50% of Early Bird Registration Fee only.
Note: Does not include travel, t-shirts, or other additional costs. Funding is limited and subject to availability.

Reimbursement:
Funds will be reimbursed after the member returns from the event and family submits Form 8.9 Check Request. Checks will be issued at the next scheduled County VMO meeting.

Request Deadline:
Requests must be submitted at least two weeks before the event’s registration deadline.

Email *

Member First and Last Name *

Parent First and Last Name (who the check should be made out to) *

Full Mailing Address (include street address, city, state and zip code): *

Phone Number: *

Fee waiver request for: (List: Event Name, Location, Date) *

Event Description: (Include website, purpose of event, etc.) *

Why are you interested in attending this event?
*

Reason for fee waiver request: *

Amount Requesting: Up to 50% of early bird registration fee only *

I understand that I will have to pay the registration fee upfront and will be reimbursed after event participation has been confirmed. *

Yes

Required

I understand that I will need to complete the 4-H Check Request Form, including all receipts, after the event and submit to treasurer@contracosta4h@gmail.com to receive a check. *

Yes

Required

Thank you!

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