Literature Request Form

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Reminders and Directions for Use:
• The projects listed on this sheet are projects that I have signed up for in 4HOnline.
• Those listed here are the ones that I want to receive literature for.
• I understand that I can choose literature for 5 projects as this is part of my member dues.
• If I choose more than 5 projects to receive literature, then I am responsible for purchasing that literature. The UW-Extension office will send a bill with my literature and I will pay it promptly. Failure to pay will suspend my 4-H member account.

Questions? Contact UW-Extension by phone at 608.785.9593 or email: LaCrosseCounty4H@lacrossecounty.org

Email *

First Name *

Last Name *

Youth Grade *

Club Affiliation *

Email Address *

Phone Number *

What is your preferred method of contact?

Phone

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Literature Choice #1 (free)

Literature Choice #2 (free)

Literature Choice #3 (free)

Literature Choice #4 (free)

Literature Choice #5 (free)

Additional pieces of literature at cost:

We will contact you once your literature is available to pick up at our office: 212 6th Street North, Suite 2200, La Crosse WI 54601.

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