4. Support statement: Should be written by someone, other than a family member, who is active in 4-H work (4-H member, volunteer, or Extension Educator, etc.). Emphasis should be placed upon the family's contribution to 4-H and their community.

___________________________________________
Signature

___________________________________________
Position

5. Authorized Signature:____________________________________________________

I have reviewed this report and believe it to be correct.

Date_______________19_____

Signed______________________________________
County Extension Agent

Return to Page 1

The Maryland Cooperative Extension Service's programs are open to all citizens without regard to race, color, sex, handicap, religion, age, or national origin.