Pertinent Info

Form due annually, by November 1st.

Name of Club*
Town - Location of club meetings*
Club Focus (horse/general/STEM)*
Are you accepting new members?*
- Yes
- No
Do you have a membership limit?*
- Yes
- No
What is the maximum enrollment for your club?*
Please enter a number greater than or equal to 1.
What is the waitlist policy for your club?*
Primary Leader*
First Last
Primary Leader Phone number*
Assistant Leader
First Last
Additional Club Volunteers
Volunteers must have completed volunteer training and must be enrolled as a volunteer through 4-H.
First Last
Additional Club Volunteers
First Last
Additional Club Volunteers
First Last
Club Officers*
President Vice President Secretary Treasurer Other
Phone
This field is for validation purposes and should be left unchanged.

President	Vice President	Secretary	Treasurer	Other