Lancaster County 4H University of Nebraska-Lincoln
University of Nebraska Cooperative Extension in Lancaster County
444 Cherrycreek Road, Lincoln, NE Email

YES, I'M INTERESTED IN JOINING 4-H!

Before you fill out the following form, take a moment to read the 3 ways you can join 4-H in Lancaster County, Nebraska HERE.

If you don't live in Lancaster County, Nebraska, contact your local 4-H office to find out about programs in your community. To find your local office, visit HERE

You can find out more about 4-H in Lancaster County by filling out and submitting this on-line form. We will be happy to send you information or give you a call. Not interested in filling out an on-line form? Phone 402-441-7180.


Kids - Get Your Parent's Permission First! Make sure you get your parent/guardian's permission before filling out and submitting the following form. Read our confidentiality statement.


1. I'd like to:

Help Form a New 4-H Club Join 4-H as an Inpendent Member
Join an Existing 4-H Club* (minimal availablility)  

Please tell us a little about yourself so we can contact you about Lancaster County 4-H:

2. Your Name:


3. Your Complete E-mail Address:

4. Your Complete Mailing Address (Street/City/State/Zip):
5. I am interested in this information as a:

(check all that apply)
parent Pre-Kindergarten Child
guardian Elementary School Student
adult volunteer Middle School/Junior High School Student
grandparent Senior High School Student
educator/teacher home school student
Other (Please describe)
6. To better help us answer your request, please tell us the first names and ages of youth interested in joining Lancaster County 4-H:

YES, I do have children interested in 4-H, please list their first names and ages (ex: Sarah - Age 9, Jamal - Age 14 or type NONE if you don't wish to list any names/ages) or do not have children interested in 4-H:

 

8. Please identify your neighborhood or location (i.e. near Clinton school, near Denton):


9. Check project areas that interest you:
(check all that apply)
Bicycles Computers Foods Livestock (beef, dairy, swine, sheep, goats, llamas) Small Engines
Cats Conservation/Wildlife Forestry Photography Theater Arts
Chess Dogs Home Environment Poultry Woodworking
Child Development Electricity Horses Rabbits For Teachers: School Enrichment
Clothing Entomology Household Pets Rocketry  
Clover Kids (For Ages 5-7) Flowers/Gardening Leather Craftsmanship Shooting Sports  

Parents/Teachers/Volunteers

10. Are you interested in becoming a 4-H Volunteer? Check your interest(s):

Club Leader Helping a 4-H'er at Home
Project Assistant Attending Meetings

Contacting by telephone:

11. You may contact me by phone.
yes
no

If yes, when is the best time to contact you?

Home Phone Number

Work Phone Number



Do you have any suggestions or comments?

If you have difficulty using this form, email Soni Cochran, Extension Associate, (scochran2@unl.edu).
 
4-H: Are You Into It?
Lancaster County 4-H

University of Nebraska Cooperative Extension in Lancaster County Confidentiality Statement

University of Nebraska Cooperative Extension educational programs abide with the nondiscrimination policies of the University of Nebraska-Lincoln and the United States Department of Agriculture.
All Rights Reserved 1996-2003