Southwind 4-H Event Scholarship Form
Complete this form if needing financial assistance to attend a district, regional, state or national 4-H event that requires a registration fee. Must be submitted prior to event. Please note the scholarship amount is event specific and will be paid to those who attend the event following the Code of Conduct.
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Email *
Full Name (First & Last) *
County which you are a 4-H member in: *
What Southwind 4-H club are you a member of? *
What 4-H event are you wanting to attend? *
How much is this event's registration fee? *
How much financial assistance are you requesting? *
Why should you be given financial assistance to attend? How will your attendance at this event benefit you as a Southwind 4-H member? *
I, the 4-H'er, acknowledge that I must comply with the Kansas 4-H Code of Conduct enroute to and from, as well as during this 4-H event to receive an event scholarship. Please type your full name below in agreeance. *
I, the parent/guardian of 4-H'er, acknowledge that I have reviewed the Kansas 4-H Code of Conduct with my 4-H'er and set expectations. Please type your full name below in agreeance. *
Please submit a copy of the event registration to allow the review committee the specific details and price. Please email to jkterrell@ksu.edu, mail it, or take to the local Extension Office prior to the event. I plan to: *
Required
A copy of your responses will be emailed to the address you provided.
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