Federation Board Application
The McDonough County 4-H Federation Board is open to any 4-H Member that is
at least 12 years or older. However, if your club is made up of members below the age
of 12 years of age then the oldest member of your club can serve as your clubs
representative. To be a Federation Board Officer you must be enrolling in your eight
grade year or older.
Application is due by June 19, 2015
Name: ______________________
Email: ___________________________
Address, City, Zip: __________________________________________________
Age: _________
Grade in School (As of Sept. 1 2011): ______________
Date of Birth: ___________
Parent’s Names: _________________________
Local 4-H Club: ________________________________________________
Years in 4-H: ____
# of Years you have attended Federation Meetings: _____
# of Federation Meetings you have attended in the past 12 months: __________
During the past year which Federation Meeting was…
Most interesting to you? _______________________________________
Least interesting to you? _______________________________________
What suggestions do you have that you feel would improve the 4-H Federation?
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
What are your goals in 4-H? ________________________________________________
_______________________________________________________________________
_______________________________________________________________________
What do you want to accomplish on the 4-H Federation Board? ___________________
_______________________________________________________________________
_______________________________________________________________________
Have you previously served on the Federation Board?
YES
NO
4-H is a community of young people across America learning leadership, citizenship, and life skills.
University of Illinois at Urbana-Champaign College of Agricultural, Consumer and Environmental Sciences
United States Department of Agriculture ▪ Local Extension Councils Cooperating
University of Illinois Extension provides equal opportunities in programs and employment.
If yes, what position(s) have you held? _________________________________
What Federation Office(s) are you applying for? (Please rank each one…1=Highest)
______ President
______ Secretary
______ Recreation Chairman
______ Vice-President (1st & 2nd)
______ Treasurer
Are you willing to attend monthly Federation meetings?
YES
NO
Have you been involved in 4-H on the County, Regional or State Level? ___________
If yes, please describe: ______________________________________________
_______________________________________________________________________
_______________________________________________________________________
List any major school and/or community activities you are now participating in:
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
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LEADER’S COMMENTS: This section is to be completed by 4-H Leader. Please forward
application to the University of Illinois Extension, McDonough County, 3022 W. Jackson,
Macomb, IL 61455.
Please evaluate this 4-H member’s qualifications for a position on the McDonough County 4-H
Federation Board of Directors. Include such items as leadership, ability, enthusiasm, and
imagination toward 4-H, ability to offer ideas, willingness to work, dependability and ability to
function well with people of all ages. Avoid any comments that would be equally true of any
good 4-H member. Use separate sheet if necessary.
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
________________
(Date)
________________________________
(4-H Member Signature)
________________
(Date)
________________________________
(Leader Signature)
_______________
(Date)
________________________________
(Parent Signature)
4-H is a community of young people across America learning leadership, citizenship, and life skills.
University of Illinois at Urbana-Champaign College of Agricultural, Consumer and Environmental Sciences
United States Department of Agriculture ▪ Local Extension Councils Cooperating
University of Illinois Extension provides equal opportunities in programs and employment.