National 4-H Dairy Youth Conference Printable Entry Form

Name Age as of January 1, 2008	Birthdate
(Note: You must be at least 15 but not more than 18 years of age as of Jan. 1, 2008 to be considered for this conference.)
County Telephone Number 4-H Agent's Name	Mailing Address Social Security Number 4-H Agent's Phone Number

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Please answer the following 6 questions fully and in your own words.

1. Are you enrolled as a 4-H member in North Carolina?   YES   NO

2. How many years have you participated in dairy youth activities?

3. List all of the dairy and dairy youth activities in which you have participated.

4. Describe what you think the dairy industry in North Carolina will be like in 10 years.

5. Describe your future educational and career plans.

6. Why would you like to be selected to attend the National Dairy Youth Conference?

Selection Procedure: Electronic and Written applications will be reviewed. Final selection will be made from those chosen for an interview.

 

All registrations are due in the Extension Dairy office by 5:00 pm June 1,2008.

No late applications will be accepted.

Entry form to be mailed or faxed to the Extension Dairy office.