4-H Citizenship Washington Focus Application

4-H Citizenship Washington Focus (CWF) Application

This application is to be completed by enrolled 4-H youth ages 14-18 who reside in Washington County, Maine and are applying to attend CWF. Three youth from Washington County, thanks to the generosity of the Harmon Foundation, could be chosen to receive a $575 scholarship to attend CWF. Participants chosen to attend CWF will be responsible for $75. Application deadline is Friday, February 21, 2020.

Name*
First Last
Date of Birth (MM-DD-YY):*
Years in 4-H (include this year):*
Address*
Street Address City State ZIP Code
Phone*
E-mail*
4-H Projects, Activities and/or Events*
Please list in order, starting with the current year and working back to your first year in 4-H. Click on the + (plus sign) to the right of the text box below to add more projects/activities/events as needed.
Year Completed 4-H Project, Activity or Event
Other Youth Organizations and/or School Activities*
Please list in order, starting with the current year and working back. Click on the + (plus sign) to the right of the text box below to add more projects/activities/events as needed.
Year Completed Organization or School Summarize What You Did
Citizenship and/or Community Service*
Please list in order, starting with the current year and working back. Click on the + (plus sign) to the right of the text box below to add more projects/activities/events as needed.
Year Completed Summarize What You Did
In 300 words or less, please tell us why you want to attend CWF.*
When you return from the trip how would you like to share your experience with others?*
- Newspaper
- Presentation at Executive Committee meeting
- Presentation at local 4-H club
- Other
If you chose Other, please explain*
Select your t-shirt size:
(all sizes are Adult)
- S
- M
- L
- XL
Please, list any special dietary requirements:
Please, list any special needs or accommodations:
When you click Submit, you will be taken to our secure payment portal, where you can pay by credit card, debit card, or electronic check. Please, have your payment details available.

Your $25 deposit will be refunded if you are not chosen to attend CWF.

Year Completed	4-H Project, Activity or Event

Year Completed	Organization or School	Summarize What You Did

Year Completed	Summarize What You Did

Cooperative Extension in Washington County

4-H Citizenship Washington Focus Application

4-H Citizenship Washington Focus (CWF) Application

When you click Submit, you will be taken to our secure payment portal, where you can pay by credit card, debit card, or electronic check. Please, have your payment details available.