Adult VolunteerMember – Enrollment Form 4-H Year: 2017-2018

4-H Adult Volunteers must also complete the 4-H Volunteer Screening paperwork.

County: ______

Family Last Name:
(this name will be used on mailing labels)

Family Phone:

Family Email:______Club: ______
Preferred Correspondence Method:  Postal Mail  Email

Member Information* indicates required fields

* First Name / Middle Name
* Last Name / Member Email
* Mailing Address / * City
* State / * Zip Code
* Gender /  Male  Female / * Primary Phone
Work Phone / Member Cell Phone
I wish to receive notices via text message /  Yes  No / Cell Phone Provider

Leadership * indicates required fields

Club Leadership /  4-H Activity Volunteer /  4-H General Volunteer
 4-H Organizational/Key Contact Volunteer

Enrollment * indicates required fields

* Ethnicity / Are you of Hispanic ethnicity?  No Yes (please indicate both an ethnicity and race)
Race /  White
 Black or African American
 American Indian or Alaskan Native /  Native Hawaiian or Pacific Islander
 Asian
 Prefer Not to State
* Residence / Farm / Suburb of city more than 50,000
Town under 10,000 and rural non-farm
Town / City 10,000 - 50,000 and its suburbs / Central city more than 50,000
* Military /  No one in my family is serving in the military
 I have a parent serving in the military /  I have a sibling serving in the military
Branch of Service
Branch Component /  Air Force  Army  Coast Guard  Marines  Navy  DOD Civilian
 Active Duty  Reserves  National Guard

Accommodations * indicates required fields

*Do you require an accommodation for a disability to participate in this program? /  Yes  No

Photo Release * indicates required fields

* May we use photographs of your child for 4-H press releases or publicity?
/  Yes  No

Volunteer Signature______Date______

The U.S. Department of Agriculture (USDA), Montana State University and the Montana State University Extension prohibit discrimination in all of their programs and activities on the basis of race, color, national origin, gender, religion, age, disability, political beliefs, sexual orientation, and marital and family status. Issued in furtherance of cooperative extension work in agriculture and home economics, acts of May 8 and June 30, 1914, in cooperation with the U.S. Department of Agriculture, Jill Martz, Director of Extension, Montana State University, Bozeman, MT 59717

Project Information4-H Year: 2017-2018

Cloverbud Enrollment:(foryouthages 5-8 by October 1, 2017)

Cloverbuds:A Discovery 4-H Program  Cloverbuds:A Palette of Fun with Arts & Crafts
 Cloverbuds: Exploring 4-H  Cloverbuds: Aerospace

ProjectEnrollment:(foryouthages 8-18 by October 1, 2017)

 / Project Description / Level
1-3, etc. / Need Project Books? /  / Project Description / Level
1-3, etc. / Need Project Books? /  / Project Description / Level
1-3, etc. / Need Project Books?
Aerospace / Goat-Breeding / Sewing & Textiles
Babysitting / Goat-Market /
  • Ready to Wear

Beef-Breeding / Home Environment / Sheep-Breeding
Beef-Market / Horse / Sheep-Market
Bicycle /
  • W. Horsemanship
/ Shooting Sports
Cat /
  • Eng. Horsemanship
/
  • Air Pistol

Child Development /
  • Horseless Horse
/
  • Small Bore Pistol

Citizenship /
  • Colt to Maturity
/
  • Air Rifle

  • Navigating Citizenship
/
  • Working Ranch Horse
/
  • Small Bore Rifle

  • Global Citizenship
/
  • Packing
/
  • BB Gun Safety

  • Interstate Exchange
/
  • Driving
/
  • Archery

Communications /
  • Showing
/
  • Shotgun

Cowboy Poetry /
  • Judging
/
  • Muzzle Loading

Crochet /
  • Green Horse
/
  • Hunting/Wildlife

Crop Science /
  • Careers with Horses
/
  • Western Action

Dairy Cattle / Knitting / Small Engines
Dog / Leathercraft / Sport Fishing
Electricity / Leadership / Swine-Breeding
Embroidery / Outdoor Adventures / Swine-Market
Entomology / Photography / Theatre Arts
Exploring 4-H /
  • Videography
/ Veterinary Science
Family Adventures / Pocket Pets / Visual Arts
Foods & Nutrition / Poultry /
  • Arts & Crafts

  • Cooking
/ Quilting /
  • Drawing…

  • Party Planner
/ Rabbit /
  • Painting…

  • Baking
/ Range Science /
  • Scrapbooking

  • Food Preservation
/ Robotics / Weed Science
  • Cake Decorating
/
  • Robotics
/ Welding
Forestry /
  • Junk Drawer Robotics
/ Wildlife
Gardening / Self-determined / Wind Energy
Goat-Dairy /
  • Project Area:
/ Woodworking
Goat-Meat / Service Learning / Other…

Committees Enrollment:
Many of our 4-H activities would not happen without the enthusiasm and energy of 4-H leaders and members. If you can help by serving on any of the committees or organizations below, please place a checkmark next to the appropriate committee or organization.

Committees
Awards-Organizes solicitation of award donors & selects award.
Meets 1-2 times a year / Exchange- This committee meets only as needed to review Exchange policy. This is not the same as enrolling in Exchange PROJECT. / Livestock-Sets policy regarding raising & selling of 4-H livestock.
Meets 4-5 times per year
Budget & Audit-Reviews expenditures & plans for upcoming fiscal year.
Meets 1-2 a year. / Fair-Makes decisions on fair activities, theme and promotion & works during the fair.
Meets 4-6 times a year. / Record Book-Judges purple ribbon books recommended by 4-H clubs.
Meets 1-2 times per year.
Demonstration-Meets as needed. / Horse-Meets 4-5 times a year. / Textile-Meets as needed.