FUNDING APPLICATION FOR WI 4-H YOUTH CONFERENCE Grades 7-10
State 4‐H Youth Conference is an opportunity for youth to come together to exchange ideas, form friendships,
and learn important skills they can use to contribute to their communities.

COMPLETE THIS FORM BY AUGUST 31

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Member Name (Last, First, Middle I)
Street Address or PO Box Number
City State Zip
Phone Number
Age on January 1 of this year
Grade this fall
Years in 4-H
Name of Parent or Guardian
Name of Primary 4-H Club
Have you attended WI 4-H Youth Conference before? If yes, what year?
Project Listing - Please list projects that you have enrolled in, indicate years, and, if presently enrolled.
Project, Number of Years, Currently Enrolled
Project, Number of Years, Currently Enrolled
Project, Number of Years, Currently Enrolled
Project, Number of Years, Currently Enrolled
Project, Number of Years, Currently Enrolled
Please list your accomplishments for some of your projects.
What are some things you have learned when participating in our projects?
Please list additional non-fair 4-H activities that you have participated in (club officer, camp counselor, L.E.A.D.S., Teen Winter Camp, Leaders Federation, etc.) with number of years:
Please list non-4-H activities that you have been active in (school, sports, church, volunteering etc.) with number of years.
What are some things you hope to learn by attending State 4-H Conference in Madison?
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