Name ____________________________________________________________________________
Age _____________________________________________________________________________
School Name _____________________________________________________________________
Grade in school ___________________________________________________________________
Address ___________________________________________________________________________
Phone ____________________________________________________________________________
Parent(s) name ___________________________________________________________________
4-H is a national youth program of the MSU Extension Service. 4-H is for all boys and girls, rural and urban, ages 6-19, regardless of socio-economic level, race, color, religion, or national origin. Each member selects and completes one or more projects per year. Youth elect their own club officers who preside at the club meetings. Each member selects and finances her/her own project.
Examples of projects are clothing, foods and nutrition, dog care and training, cat care, vegetable gardening, aerospace, electricity, photography, livestock, and others. Projects are designed so that members "learn by doing."
Do you think you would be interested in joining a 4-H club if one is organized in your community? o Yes o No
FOR PARENTS
Were you ever a 4-H club member? (mother) o Yes o No If yes, where? _________________
Were you ever a 4-H club member? (father) o Yes o No If yes, where? __________________
Would you help with a group of boys and girls in a 4-H club? (mother) o Yes o No
Would you help with a group of boys and girls in a 4-H club? (father) o Yes o No
Parent signature __________________________________________________________________
Parent Interest Survey
4-H is an educational youth organization in which the whole family can work together and have fun. If our club is going to be successful, we will need help from all members and parents.
To make the 4-H club programs worthwhile, I will help to the best of my ability with the following:
Chances to Serve
o Provide transportation for 4-H'ers going on a tour
o Provide refreshments
o Provide supplies for a special project
o Contact other parents to help with club activities
o Assist with one club meeting
o Help teach a member how to give a demonstration
o Assist with recreation at a club meeting
o Be an assistant organizational leader
o Be an assistant project leader
o Assist with officer training
o Be a project leader
o Be an organizational leader
o Orient new families to the club
o Other
I have special interests or hobbies in
1.
2.
3.
4.
It is easiest for me to give my time: (check appropriate times)
o Weekday mornings
o Weekday afternoons
o Weekday nights
o Saturdays
o Sundays
In the o Summer o Fall o Winter o Spring
Parent Signature ___________________________________________________