UMaine | A-Z Directory | MaineStreet | Campus Map | Calendar

Cooperative Extension

The Universty of Maine logo

2013 Summer of Science

Teen Reaching Youth (TRY) Application

Funded by theYouth Voices, Youth Choices program of National 4-H Council and Sustainable Youth, Families and Communities Team of UMaine

 Due: June 1, 2013

Once you start filling this form it can not be saved

 Questions? Call Mitch Mason at 781-6099 or email him at mitchell.mason@maine.edu

 First Name:    Last Name:

 Mailing Address:  

City:     State Zip:  

4-H Club (if in a club):

Home Phone: Email

 Emergency Contact Name: & Phone:  

School: (current school, not next year)

Age (on June 1, 2013) :      

T-Shirt Size (Adult sizes)

(check one):  XSM          SM         MED      LG          XL         XXL

 1. Describe previous leadership experiences, including community, school, 4-H, and other organizations. This may include elected offices, serving on committees or boards, or efforts in planning and organizing events and activities:

 

 2. Describe previous teaching and/or public speaking experiences, including community, school, 4-H, and other organizations:  

 3. Describe previous 4-H involvement (if any):

List major 4-H, school, and/or community accomplishments and honors:

5.  In 50 words or less explain why you think it is important for young people to eat well and exercise:

 5.  In 50 words or less explain why you think science is important to your community:

 

  YES     NO    I have discussed the responsibilities of this leadership role with my family and am prepared to fulfill the commitments.

 YES     NO    I can attend the mandatory training on June 24, 2013.

1. Fill in application and submit.
2. Print confirmation page
3. Applicant and parents sign confirmation page
4. Send signed confirmation page by June 1, 2013 to:
UMaine Extension, Cumberland County, 75 Clearwater Drive, Suite 104, Falmouth, ME, 04105 att. Lisa Waters
or fax to 207-781-5983
or e-mail (for scanned apps): lisa.waters@maine.edu