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| ABOUT 4-H | VOLUNTEERS |
For a printable version of this document, click here
National 4-H Trips
National 4-H Congress November 27 - December 1, 2009- Atlanta
National 4-H Conference March 20 to 25, 2010 - Washington DC
Application
Applying for Congress o Conference o Both o
Biographical Information
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DELEGATE'S NAME |
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Name as it appears on driver’s license or picture ID |
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Name as it should appear on name tag |
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Mailing Address
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City/State/Zip Code
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E-mail Address
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Phone numbers
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Home Cell
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Tee Shirt Size
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o Small o Medium o Large o XL o 2XL |
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Gender
o Male o Female |
Date of Birth |
Age as of 1/1/09
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Number of Years in 4-H |
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4-H member was re-enrolled by December 31, 2008 o
County Staff Signature
Educator or Professional
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