GREENE COUNTY
RR 3, Box 129C, Carrollton, Illinois 62016
Telephone: 217/942-6996
Fax: 217/942-3827
Web site: http://www.extension.uiuc.edu/greene/
4-H Leader Of The Year Nomination Form
Greene County 4-H will be presenting a special award each year beginning with the 1997 4-H
Achievement or the 4-H Leader of the Year.
Nominations may be made by 4-H members, parents, or 4-H alumni. All applications must be
signed at the bottom by the person(s) making the nomination and are to be returned to the Greene
County Extension Office no later than August 31, 2006 at 4:30 p.m.
Name of Nominee _____________________________________________________
Name of Club _________________________________________________________
Tell why you think this leader should be named 4-H Leader of the Year.
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You may use the back of this form or add additional pages if needed.
Name of person submitting the nomination ______________________
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.