Due to the Greene County Extension Office by September 15
Greene County 4-H Awards Application
Adult Volunteer Awards
Nomination Form
______________________________________________________________________________
On behalf of the Greene County 4-H Program, the 4-H Record Book Evaluation Committee presents awards
to our adult volunteers who are nominated by their peers, youth and/or staff.
Please fill out this form for an adult volunteer that you think is worthy to receive one of the following awards.
I would like to nominate: _________________________________________________________
Address ___________________________________________________ Phone _____________
Please select award you would like to nominate this volunteer for:
_____ Honorary Member
To be eligible for this award, the individual must have never been a 4-H member, and someone who
supports the Greene County Youth & 4-H Program in his/her personal life.
_____ 4-H Alumni
To be eligible for this award, the individual must have been a 4-H member in any county or state
who has continued to promote the goals of 4-H and has displayed continuing interest and support to
the Greene County Youth & 4-H Program.
_____ Meritorious Service
To be eligible for this award, the individual(s) must have provided a number of years of service &
leadership to the Greene County Youth & 4-H Program.
_____ Friend of 4-H
To be eligible for this award, the individual/business must have promoted the goals of 4-H and have
supported the Greene County Youth & 4-H Program personally and/or professionally.
Please state why you think this person should be recognized:
You may attach your recommendation or you may write it below or on the back of this sheet.
Submitted by _______________________________________________ Date _______________
Phone number you can be reached at by the selection committee: _________________________