registration for 4-h legislative trip

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January 2015
To: 7th and 8th Grade 4-H Members & Friends
Re: 4-H Legislative Trip to Des Moines
Come join us as we travel by bus with other 4-Hers to Des Moines, tour the State Capitol complex, visit with
elected officials, gain a greater understanding of our Iowa state government and learn about our great schools
and people. On Wednesday, February 25, 7th and 8th grade 4-H members & friends are planning to visit the
Judicial Center, Iowa Legislature and Capitol in Des Moines, have lunch with legislators and explore the
Science Center of Iowa. Initial information follows:
WHEN: Wednesday, February 25, 2015
WHO: Any interested 7th and 8th grade 4-H members & friends. 4-H members may invite a friend in 7th or 8th
grade who is a non-4-H member but they must pay the fee and register by the deadline. Space is limited
to 49 participants - register early!
COST: Jones County 4-H Member Cost: $35 (Region 10 cost per member: $50, however each Jones County 4-H
Member will automatically receive a $15 Scholarship.) Registration & payment of fees are due Feb. 11.
Fees after February 11th are $45. This fee covers transportation, insurance, Science Center of Iowa
and noon lunch.
SCHOOLS: A letter will be sent that can be used by your 4-H members to give to Middle School
administrators explaining this opportunity. Individuals will be responsible for obtaining
permission from their schools to be absent.
DEPARTURE: Please specify on your registration form where you will be getting on the bus at.
6:00 am Jones County Extension & Outreach Office, Monticello
6:30 am Linn County Extension & Outreach Office, Cedar Rapids
7:45 am Benton County Extension & Outreach Office, Vinton
RETURN: Departure from the Science Center of Iowa will be approximately 3 pm.
Please complete the enclosed registration form (with check made payable to Jones County Extension &
Outreach) and make sure you have enrolled in 4-H for the current year including your Health Form, required for
liability purposes. A health form must be completed along with registration for all non-4-H members. Return
registration form and payment to the Jones County Extension & Outreach Office by February 11th, 2015.
Parents/Guardians –There is limited space for chaperones including a $15 per chaperone charge to cover the
cost of your lunch and the I-Max Theater. If you are interested in chaperoning this trip, please contact your
County Extension & Outreach Office.
Join us to learn about your state, meet new friends and have fun!
Sincerely,
Michelle Thomsen
Monica Gray
County Youth Coordinator
Jones County Youth Program Coordinator
Monica Long
Jacki Luckstead
County Youth Program Coordinator
Region 10 Youth Program Specialist
4-H Legislative Trip Registration Form
Wednesday, February 25, 2015
Jones County 4-H member Cost: $35 - Registration is limited
Region 10 cost per member - $50, however each Jones County 4-H Member will automatically receive a $15 Scholarship
Name: __________________________________________________
Grade (circle one): 7
8
Mailing Address: _________________________________________ City: ___________________________
4-H County (circle one): Benton Jones Linn
Other _________________________
Email Address: ___________________________________________________________________
Home Phone Number: _________________________
School: __________________________________________________________________________
Emergency Contact: ____________________________________________
Emergency Contact’s Phone Number: ____________________________________
Food allergies: _________________________________________________
Please answer the following the questions…
Who is your local State Senator in the Iowa Legislature: ________________________________________
Who is your State Representative in the Iowa Legislature: ________________________________________
What is one question you could ask your Senator or Representative?
When did the current Legislative session begin?
What major issues will legislators be discussing this session?
Have you been to the State Capitol? (Please circle one)
Yes
Have you been to the Iowa Science Center? (Please circle one)
No
Yes
No
Registration form and $35 fee (checks made out to Jones County Extension)
DUE by February 11, 2015 to:
Jones County Extension & Outreach Office
800 N. Maple St., PO Box 28 | Monticello, IA 52310 | (319) 465-3224
The schedule & transportation plans will be finalized & e-mailed out the week of February 16, 2015.
If you have any questions, please contact your County Extension & Outreach Office directly.
The fees for services will be used to off-set and support the 4-H Youth Development Extension Programs in Region 10.
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