Key Leader Application

Hocking County Key Leader Application

Print out this form, complete the application and return to the County Extension Office by:

NAME_______________________________________________________________________

ADDRESS___________________________________________________________________

Phone(day)__________________________________(evening)__________________________

Email address: ________________________________________________________________

Are you currently a 4-H club advisor in Hocking County? _____yes _____no

If so, what is the name of your club?________________________________________________

Have you completed an Ohio 4-H Volunteer Application, Standards of Behavior & Interest Check list? _____yes _____no

What is your area(s) of specialization in which you would like to be a Key Leader, and why.

_____________________________________________________________________________

Why do you feel this area needs a Key Leader?

____________________________________________________________________________

Please list some qualifications you believe would make you a good choice as a Key Leader in this area.

____________________________________________________________________________

As a Key Leader I promise to do my best to provide information and instruction to those in need of my assistance, and to cooperate with the Hocking County 4-H Committee, Extension Staff, Junior and Senior Fair Boards and others as needed.

Signature_____________________________________________________Date_____________

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All educational programs conducted by Ohio State University Extension are available to clientele on a nondiscriminatory basis without regard to race, color, creed, religion, sexual orientation, national origin, gender, age, disability or Vietnam-era veteran status.

Keith L. Smith, Associate Vice President for Ag. Admin. and Director, OSU Extension TDD No. 800-589-8292 (Ohio only) or 614-292-1868

Updated: October 2004