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Maine 4-H Animal Science Committees

Member

Nomination & Re-Nomination Form

 

 

 

 
Today's Date_________________

 

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 signed and dated statements from:

1. Extension Educator/Professional—statement of support for this nominee
2. Nominee—why nominee would like to serve on the committee, strengths nominee brings to the committee
3. Current animal science committee member OR other 4-H leader—statement of support for this nominee

 

 

Completed Nominations

Send completed nominations and three letters of support to the State 4-H Office

 

State 4-H Office

ASC Nomination

5741 Libby Hall

University of Maine

Orono, ME 04469

 

Deadline is October 1

 

 

 

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 and date your statement.

 

Thank you!

 

 

Adopted 05-03

Updated: 9/10/08