This application is for (circle ONE): County Council or ELITE Project Team

Name:______________________________________Youth Phone #:____________________________

Youth email: ___________________________________________________________________________

Address:____________________________________________ Club Name:_______________________

School District: ______________________________________ Age:________Years in 4-H:________

Due to the Extension Office by September 3 rd @ 4:30 p.m.

 This Application Form

 Resume of 4-H, school, church and community activities

Please fill out the entire application with ink or by typing.

A copy can be emailed to you upon request. Please use an additional sheet if needed.

1.) Why do feel this group is the best match for you?

2.) Why do you feel you should be selected to this group? What will you offer this group?

3.) What are goals you have for this group?

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4.) Please share examples of your leadership growth in the last year. Be specific!

5.) How many hours a month do you expect to contribute to this group: ____________

The following questions will help the selection committees see your learning, leadership, and communication styles. Please pick only one answer. Feel free to write additional information if you need to defend your answers.

5. When communicating, I like to: 10. Are you more quiet or talkative? a.

Take time to understand and ask questions __________________________________________ b.

Listen to others before I have ideas c.

Be specific and move along quickly 11. Do you go along or take charge? d.

Think before I speak _______________________________________ e.

Be casual, humorous, or playful f.

I prefer not to share in groups

6. I tend to communicate to: a.

Gather specifics and fulfill responsibilities

12. Are you more cooperative or competitive?


13. Do you avoid risks or take risks? b.

Figure things out and problem solve c.

Connect with others and make a difference d.

Make an impact and have fun

7. In a group, I am often the one: a. Listens b. Starts conversation c. Can brainstorm the most ideas


14. Are you more reserved or more outgoing?


15. Are you more people-oriented or task oriented? d. Keeps the group on track

8. I prefer to solve problems/plan activities by a. Working in a group b. working with one other person c. being told what to do d. working alone


16. Are you more open or closed?


17. Are you easy to know or hard to know?


9. I would most often be described by my teachers as a. the listener b. the thinker c. the challenger d. the free spirit e. the talker f. the doer

18. Are you more informal or formal?


19. Are you more responsive or nonresponsive?


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