2015-2016 Iowa County 4-H Youth Council Application
Name: _____________________________________Club: __________________________________________
Address: ________________________________________ City: ______________________ Zip: ___________
Home Phone: __________________________________ Cell Phone: __________________________________
Email Address: _____________________________________________________________________________
School: ____________________________________ Grade: _______
Age: _______ Year in 4-H: _________
Why would you like to serve on the 4-H Youth Council? _____________________________________________
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What leadership experiences have you had in 4-H: __________________________________________________
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Community Service Activities: __________________________________________________________________
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School Activities: ______________________________________________________________________________
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What do you feel the youth council should expect of its members: _____________________________________
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Identify 2 ways 4-H can keep members enrolled in the program: ______________________________________
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The following additional information is for a 4-H feature that Iowa County would like to print in the local media.
Family Members: _____________________________________________________________________________
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4-H Projects: _________________________________________________________________________________
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4-H Activities: ________________________________________________________________________________
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Special 4-H memory/highlight: __________________________________________________________________
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Future Plans: _________________________________________________________________________________
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Quote: How has 4-H helped you? What have you gained by being a 4-H member? _______________________
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4-H Leaders: _________________________________________________________________________________
Please enclose a photo when you return your application.
Return application form by June 10th, 2015 to:
Iowa County Extension Office
Attn: Youth Council Advisor
PO Box 720
Williamsburg, IA 52361
05/2006