Marion County 4-H Development Committee
Nomination Form
Please use this form to nominate a candidate to serve on the Marion County 4-H Horse
Development Committee. Nominees must be currently affiliated with the Marion County 4-H
Horse Program. All nomination forms must include the signature of the nominator and the
nominee. Self-nominations are acceptable.
Candidates nominated through this process will be placed on the ballot to fill current committee
vacancies. Nominations must be submitted no later than the scheduled September committee
meeting. Selections of new committee members will be made by a vote at the scheduled
October committee meeting.
Return nominations form to Marion County Extension Office, 3180 Center St NE, Salem, OR
97301.
NOMINEE: ___________________________________________PHONE:_________________
ADDRESS: _______________________________CITY:__________________ZIP:_________
4-H Leader:_____________Senior 4-H Member:_________Parent:________Other: _______
Club Affiliation:_______________________________________________________________
Qualifications: (4-H Horse Experience; Areas of Interest/expertise: ___________________
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Comments:__________________________________________________________________
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Candidate Signature
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Date
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Nominator Signature
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Date