2016 WISCONSIN 4-H YOUTH CONFERENCE
PAYMENT WORKSHEET-INVOICE FOR _____________________COUNTY
(NAME OF COUNTY)
DELEGATION PROFILE/REGISTRATION CHARGES
Number
Persons attending
Youth Delegates and Ambassadors*
Adult Advisors
Cost each
$240 $
240
SUBTOTAL OF REGISTRATION CHARGES (Enter this subtotal on next page.)
Total
$
SEMINAR FEES: (Please note seminar fees are waived for Adult Advisors.
Classroom/bus space is limited so delegates may not receive their first choices.)
Number in
seminar
Seminars with fees
Cost each
130: Attracting Eastern Bluebirds…
$10
211: It Is Rocket Science!
7
264: Sailing
35
265: Windsurfing
35
462: Introductory Kayaking
35
463: Introductory Canoeing
35
464: Sailing
35
465: Windsurfing
35
484: Gardening Art
5
562: Introductory Kayaking
35
564: Sailing
35
565: Windsurfing
35
Total
$
SUBTOTAL SEMINAR FEES (Enter this total on next page.)
CREDITS
Wisconsin 4-H Foundation Support:
$240 full support for Adult Advisor if your county has 15 or fewer delegates.
$480 full support for two Adult Advisors if your county has 16-30 delegates.
$ ________
TOTAL OF CREDITS (Enter this credit subtotal on next page.)
*Members of Art Team, Communications Team, and Drama Company are invoiced by their Advisers.
(over)
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(WI 4-H & YOUTH CONFERENCE PAYMENT WORKSHEET, CONT’D.)
Note: Counties are expected to split costs of non-supported, shared Adult Advisors among
themselves. The Adult Advisor’s county pays for his/her registration and collects half (or one
third each if three counties are sharing) from the second (and third) counties.
Subtotal of registration charges from previous page
Subtotal of seminar fees from previous page)
Add total registrations and seminar fees
Subtract the total credits from previous page
TOTAL DUE:
$ __________
$
$ __________
$
$ __________
Submit one check payable to UW-Extension and enclose a copy of this worksheet.
DUE JUNE 1
To WI 4-H Outreach, 436 Lowell Hall, 610 Langdon St, Madison WI 53703-1195
For Office Use Only
Check #_____________________ dated _______________ for $__________________.
Wisconsin 4-H Foundation proudly supports this
UW Extension 4-H Youth Development program in the amount of $10,000
which covers registration for county Adult Advisors and offsets
participating county individual youth costs by about $25 each.
An EEO/AA employer, University of Wisconsin Extension provides equal opportunities in employment and programming, including Title IX and
American with Disabilities (ADA) requirements. If you need an interpreter, materials in alternate formats or other accommodations to access this
program, activity or service, please contact Kay Hobler, WI 4-H Outreach at 608-262-1557 as soon as possible preceding the scheduled event so
that proper arrangements can be made in a timely fashion.
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