UMaine Cooperative Extension logo 4-H banner showing children, UMaine Extension logo, and 4-H clover  
4H: Bringing the University to youth  
ABOUT 4-H

YOUTH

FAMILIES

VOLUNTEERS

4-H ALUMNI

JOIN 4-H

DONATE

 

 

For a printable version of this document, click here

 

National 4-H Trips

 

National 4-H Congress November 28 - December 2, 2008- Atlanta

National 4-H Conference March 28 to April 2, 2009 - Washington DC

 

 

Application

Applying for Congress  o         Conference  o        Both  o

Biographical Information

 

DELEGATE'S NAME

 

 

 

Name as it appears on driver’s license or picture ID

 

 

 

Name as it should appear on name tag

 

 

 

Mailing Address

 

 

 

 

City/State/Zip Code

 

 

 

 

E-mail Address

 

 

 

 

Phone numbers

 

Home                                                 Cell

 

 

Tee Shirt Size

 

 

o Small      o Medium      o Large      o XL       o 2XL

Gender

 

o Male     o Female

Date of Birth

Age as of 1/1/08

 

Number of Years in

4-H

 

 

 

4-H member was re-enrolled by December 31, 2007   o

 

County Staff Signature 

Educator or Professional

 

_______________________________________________