VOLUNTEER/TEEN FORUM

Scholarship Application

Deadline for Submission: December 1, 2009

NAME:  _____________________________________________________________

ADDRESS: __________________________________________________________

EMAIL: _____________________________ TELEPHONE: __________________

ADULT: ___________ YOUTH: ___________CLUB: _______________________

Amount you paid to register for this event: ______________________________________

Please explain why you wanted to attend this event and what you gained from the experience:

*The Volunteer/Teen Forum Scholarship Fund will be divided equally among those applying and the award per person will not exceed the cost of the registration fee. This scholarship cannot be applied to any county residential 4-H Camp.

* If you received a scholarship for Teen Focus you are not eligible to receive one for Teen Forum.

*All recipients must be an enrolled 4-H member.

*All scholarships will be awarded at the discretion of the Anne Arundel County 4-H Foundation.

*All scholarships will be awarded after successful completion of the event.

Please mail to:        A.A. County 4-H Foundation

         7320 Ritchie Hwy, Suite 210

         Glen Burnie MD 21061

Applications postmarked after the deadline will not be accepted.

“It is the policy of the University of Maryland, Agricultural Experiment Station and Maryland Cooperative Extension, that no person shall be subjected to discrimination on the grounds of race, color, gender, religion, national origin, sexual orientation, age, marital or parental status or disability.”