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Jefferson County

jeffco@jeffersoncountywi.gov

311 S. Center Avenue, Jefferson, WI, 53549, US

Jefferson County 4-H Educational Travel Opportunity Application

Name

Address

Date of Birth

Date Picker

Evaluation of My 4-H Program 

List projects you have been enrolled in; indicate years and if presently enrolled. Be selective if necessary.

Upload one page of 2 to 3 photos of you with captions that demonstrate what you have
accomplished and learned through your 4-H projects and activities.

Upload File(s)

Click Here to Upload

Leadership & Participation

List Your 4-H Leadership (offices held, committee chair, events you planned, projects led, etc.)
Include the year, a description and location. 

List Your 4-H Club Participation (community service, demonstrations, committees, trips, tours, recreation, etc.)
Include the year, a description and location. 

List Your 4-H County/District/State/National Participation (committees, fair, MAP, trips, tours, events, etc.)
Include the year, a description and location. 

List Your Non-4-H Activities (school, church, community, sports, work, FFA, livestock associations, etc.)
Include the year, a description and location.