Brown County 4-H Award Nomination Form

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Please complete this form with your program year award nominations prior to October 1st. Complete this form the best that you are able, and utilize your fellow club leaders, officers, and families to complete as much of this form as possible. The Ambassadors and Awards Team will make the final decisions on awards.

Contact the Extension Office for a print version of this form.

Identification

Name of 4-H Member (youth or adult) completing this form *

Which Club do you represent? *

Burnstown/Brookville

Comfrey Comets

Golden Rose Riders

Milford

North-west Wildflowers

Sleepy Eye Wide Awakes

Stark Happy Hustlers

Other:

Required

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