Return To: Dodge County Extension Office

Return To: Dodge County Extension Office

<p> MINNESOTA 4-H SHOOTING SPORTS & WILDLIFE PROGRAM YOUTH AMBASSADOR REFERENCE FORM </p><p>Applicant’s Name: Name of Individual Giving Reference: First Name: Last Name: Title: Telephone: (_____) How long have you known the applicant? </p><p>The above named person is applying for a volunteer position with the Minnesota 4-H Statewide Shooting Sports and Wildlife Program. Youth will attend a two-day training in which they will learn aspects of the Minnesota 4-H Shooting Sports and Wildlife Program, develop personal vision statements, and learn skills in public presentation, etiquette, and partnerships development. Expectations of the ambassador will include:  Enrolled as a Minnesota 4-H Member  Be a positive role model at the club and county program levels  Be knowledgeable in the Shooting Sports and Wildlife Areas  Be actively engaged in the program and attend events throughout the year</p><p>It is of great importance to us to obtain as much information as possible about the applicant’s abilities and character in order to select the most qualified ambassadors to represent our youth program. Any information you provide will be regarded as strictly confidential.</p><p>Thank you for your time and thoroughness in answering the following questions:</p><p>Describe the applicant’s personality.</p><p>Describe the applicant’s strengths.</p><p>Please check the characteristics below that best describe the applicant: (Check all that apply)</p><p>LEADERSHIP Always takes the lead Comfortable in leadership roles Prefers to follow</p><p>EMOTIONAL TEMPERAMENT Balanced and controlled Unpredictable Always cheerful Over-responds emotionally Tends to be moody Other: ______</p><p>SOCIAL INTERACTION Well liked Sought out by Others Tolerated by Others Avoided by others Usually just blends in</p><p>Additional Comments:</p><p>Signature ______Date______</p><p>Thank you for helping us find the best possible representatives of our youth program! Please return form to: Extension Regional Office, Rochester, Attn: Nicole Pokorney, 863 30th Avenue SE, Rochester, MN 55904 Return form: Fax: 507-536-6311 or e-mail: [email protected]</p>

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