Name of County Extension Council
Street Address
City, State. Zip
123-456-7890
123-456-7890
E-MAIL name@missouri.edu
WEB extension.missouri.edu
PHONE
FAX
UNIVERSITY OF MISSOURI EXTENSION
BALLOTS FOR EXTENSION COUNCIL MEMBERSHIP
Place an X in the box by the name of the person of your choice. (Each person votes for only one nominee for
each position.)
for two-year term
for two-year term
for two-year term
for two-year term
for one-year term
for one-year term
Eligible voters who reside in District II may vote for one candidate for a two-year term, and one for a one-year
term. (Where someone has resigned, this example might apply.)
NOTE: This should be adapted to fit each county situation. District numbers or names should be added if such
apply and if the ballot is for more than one district. All nominees will be voted on for a two-year term unless
there is a vacancy to be filled. The statement, "University of Missouri Extension does not discriminate on the
basis of race, color, national origin, sex, religion, age, disability or status as a Vietnam-era veteran in
employment or programs" should be included on the ballot.
University of Missouri, Lincoln University, U.S. Department of Agriculture and Local Extension Councils Cooperating
EQUAL OPPORTUNITY/ADA INSTITUTIONS