2023 CORE Academy Application
CAREER OPPORTUNITIES REFLECTING EXCELLENCE
Cost: $250.00 per student DUE: April 15th
Checks Payable: 4-H CORE Academy, 38 Business Court, Fredericksburg, TX 78624
If not selected for the tour, your money will be refunded in full. (minus any credit card fees) 

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Name
Date of Birth
MM
/
DD
/
YYYY
Grade Completed (2022-2023)
Age
Gender
Youth Phone No. (mobile)
Address (Street, City, Zip Code)
County
Youth Email
Parent/Guardian Name
Parent/Guardian Phone No. (mobile)
Parent/Guardian Email
Have you attended CORE Academy before?
Clear selection
T-shirt Size (adult sizes)
Clear selection
County Agent Name and Email
Number of years in 4-H
Offices held (local, district, state)
Project/Activity Involvement (list up to 10)
Why do you want to participate and what do you hope to gain from this opportunity?
What career would you like to pursue in the future?
List other extracurricular activities you are a part of.
By submitting this document the applicant and parent/guardian acknowledge that if chosen, the applicant is expected to fulfill the agreement of attending all activities during this event. 
(All health forms and medical release forms will be sent 30 days prior to the event start date)

Method of Payment
(Information on processing payment will be sent after you have submitted the application)  *
Required
Programs of Texas A&M AgriLife Extension and the Texas 4-H Youth Development Program are open to all people  without regard to race, color, sex, gender, sexual orientation, religion, national origin, age, disability, genetic  information, or veteran status.
If you need any type of accommodation to participate in this program or have questions about the physical access  provided, please contact Shea Nebgen at 830-997-3452 by April 15th.
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