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Maine 4-H Animal Science Committees

Member

Nomination & Re-Nomination Form

 

 

 

Nomination or Re-nomination for: Beef   Dairy  Dog   Goat   Horse   Sheep   Working Steer

 

Nominee:

Name:            _______________________________________________________________

Address:        _______________________________________________________________

                        _______________________________________________________________

Phone:           _______________________________________________________________

Email:            _______________________________________________________________

County where nominee is enrolled as a Maine 4-H Volunteer:  ___________________

Date VOLT completed:  ________________ or will be completed:  ________________

For current or past ASC members:

        Committee:  _______________________  Term dates:  __________ to __________

 

Support for nominee:  (Include statement(s) from the nominee, current committee members, current Activity Coordinator, or Extension employees regarding why the nominee wants to be on the committee or why the nominee would be an asset to the committee – use additional sheets if more space is needed.)

 

Please sign your statement.

 

 

 

 

 

 

 

 

 

 

 


 

 

 

 

Nomination decisions:       

Extension Educator or Professional:

Accepted:  ___________    Denied:  ___________     Date:  _______________

Signature:  _______________________________________________________

ASC Staff Liaison:

Accepted:  ___________    Denied:  ___________     Date:  _______________

Signature:  _______________________________________________________

ASC Members:

Accepted:  ___________    Denied:  ___________     Date:  _______________

Signature of Activity Coordinator:  __________________________________

 

Reasons for Denial of Nomination:  (In situations where a nomination has been denied, the individual or group denying the nomination should write a brief statement addressing why the nomination was denied.)

 

Please sign your statement.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Thank you!

 

 

Adopted 05-03

Updated: 10/23/06