Ple=
ase
return this form to you local Extension center.
Is =
your
club recruiting new members? _______ Year Founded (if
known)___________________
Nam=
e of
meeting place ___________________________________________________
Str=
eet
address ___________________________City ___________________ Zip ___________=
GIS
coordinates _______________________________________________________________=
(Use latitude & longitude decimal degrees)
Club
Contact: (Should be adult leader or
How=
many
members fall in these age categories:
8-10 _____ &n=
bsp; 11-13
_____ 14 -18 ______
Doe=
s your
Club have a Clover Kids group? ____ Number of Clover=
Kids?________
Cir=
cle all
project or activity areas of your club:
|
<= o:p> A=
erospace |
C=
lothing
and Textiles |
E=
nvironmental
Science |
H=
ome
Environment |
S=
mall
Engines |
|
<= o:p> A=
mphibians
and Reptiles |
C=
ommunication |
P=
ersonal
Finances |
H=
orses |
C=
rops |
|
<= o:p> A=
rts and
Crafts |
C=
omputers |
F=
orestry |
L=
eadership |
S=
port
Fishing |
|
<= o:p> B=
eef |
C=
ooking
and Foods |
<= o:p> G=
ardening
and Horticulture |
P=
hotography |
S=
wine |
|
<= o:p> B=
icycle |
D=
airy |
G=
eology |
P=
oultry |
V=
eterinary Science |
|
<= o:p> C=
ats |
D=
ogs |
G=
lobal
Education |
R=
abbits |
W=
elding |
|
<= o:p> C=
hild
Development |
E=
lectricity |
G=
oats |
S=
heep |
W=
ildlife |
|
<= o:p> C=
itizenship |
E=
ntomology |
H=
ealthy
Lifestyles |
S=
hooting
Sports |
W=
ood
working |
|
<= o:p> O=
ther:
(describe) |
<= o:p> |
<= o:p> |
<= o:p> |
<= o:p> |
Bri=
efly
describe your club’s service activity.
Club
website URL: _____________________________________
Inf=
ormation
will be posted on WWW to help market the 4-H program to prospective members=
. http://msdis-maps.m=
issouri.edu/website/4HClub