Javascript is required to load this page.
Page Loaded
Deutsch
English
Español
Español (América Latina)
Français
Italiano
Nederlands
Português
Português (Brasil)
Suomi
한국어
日本語
简体中文
繁體中文
For what school district and campus do you intend to apply?
School District
Campus
What County is your school district in?
County
Please enter the first name and last name of the principal that will host your program.
First Name
Last Name
What is the principal's email address?
Email Address
What is the best telephone number to reach the principal?
Daytime Telephone Number
Please indicate which grades you are targeting.
3rd-5th
6th-8th
9th-12th
Please indicate the projected number of youth participating:
Please indicate the following:
After-School Program
In-School Program
Please indicate the following:
Fall Semester only
Spring Semester only
All-Year
Please indicate which 4-H curriculum your school/campus would be interested in:
Please indicate which 4-H curriculum your school/campus would be interested in:
Fall Semester
Spring Semester
All-Year
Agriculture & Livestock
Fall Semester
Spring Semester
All-Year
Family & Community Health
Fall Semester
Spring Semester
All-Year
Natural Resources
Fall Semester
Spring Semester
All-Year
Leadership & Citizenship
Fall Semester
Spring Semester
All-Year
STEM
Fall Semester
Spring Semester
All-Year
Other
Fall Semester
Spring Semester
All-Year
If you selected Other 4-H curriculum, please specify below:
Please fill in any additional information you would like for us to know, including other projects and/or activities you are interested in:.
Survey Powered By
Qualtrics