Lancaster County Meritorious Service to 4-H Award Nomination Form | Nebraska Extension in Lancaster County

Due January 3

Each year, Lancaster County 4-H presents a Meritorious Service to 4-H Award to an individual or organization which have exhibited consistent and strong support of the Lancaster County 4-H program. 4-H members are not eligible.

Recipient(s) will be announced at Lancaster County 4-H Achievement Celebration (usually held in February).

Nominations may be made by 4-H leaders, parents or friends. They may also be self-nominated.

Note: This form cannot be saved in-process. It must be completed and submitted in one sitting.

Nominee:

Name of individual or organization: Required

Contact Person (if is an organization):

First

Last

Suffix

Address:

Address Required

Address 2

City/Town Required

State/Province Required

ZIP/Postal Code Required

Phone (daytime): Required

Meritorious Service:

Write a brief statement of the meritorious service. Required

Nominator:

Name:

First Required

Last Required