4-H Dairy Showcase Application - Leadership Profile Note – this is a worksheet only, applications must be submitted online at www.fourh.umn.edu/dairyshowcase

Name:

Mailing Address:

City: State: Zip:

Date of Birth (format March 28, 2001):

School grade completed: County:

Email Address: Cell phone number:

Parents Names, First and Last (as you would like them listed in promotional materials) ______

Local (home town) newspaper name, phone and/or email ______

Indicate 4-H Dairy project involvement and leadership (No more than 750 characters in the online form - about 100 words)

Indicate 4-H Leadership: (years, offices, committee work, awards). Must include 2015 (No more than 750 characters in the online form - about 100 words)

Indicate other dairy related involvement and leadership. (No more than 300 characters in the online form - about 50 words)

Indicate school, faith-based, community activities and service. (No more than 300 characters in the online form - about 50 words)

The dairy industry has evolved into a broad range of herd sizes, from less than 100 cows to more than 3,000 cows. What size of herd did you work with as part of your 4-H dairy project? What have you learned from this style of dairying that will prepare you for your future? (No more than 500 characters in the online form - about 75 words)

In the context of size of the dairy operation, where do you see the Minnesota dairy industry in 15 years? What positive changes should the Minnesota 4-H program consider to stay abreast of dairy industry trends? (No more than 500 characters in the online form - about 75 words)

Reference information of a non-related adult who can serve as a reference:

Name:

Address:

Phone number:

Cell phone number:

Briefly explain relationship with this individual (i.e. 4-H Club Leader):

To confirm your answers online, and verify your identity, you will be asked for your mother’s maiden name: