Page one of the 4-H Member Financial Assistance Application     Alternatively, download a printable Cascade County 4-H Member Financial Assistance Application.

Participant Information

Member Name:

Parent/Guardian Name:

Parent/Guardian Email:

Parent/Guardian Phone:

Please mark if applicable

I would like to be listed as anonymous to the Leaders Council/Foundation Executive Committee

Application Information

Event or Activity I would like to attend: 

Date(s) of the Event or Activity:

Total Cost:

Amount I am able to pay:

Amount Requested:

Signatures

Member Signature

Date

Parent/Guardian Signature
Date
Officer Signature
Date
County Extension Agent Signature
Date

Supplemental Information

  1. To be completed by the youth member or dictated to parent/guardian, Extension staff, or volunteer leader. Your application will not be considered if this section is left blank. Please tell us why you would like to participate in this event or
  2. To be completed by the parent/guardian. Your application will not be considered if this section is left blank. Please share a statement of financial

Thank you for your application for 4-H Member Financial Assistance. The Leaders Council/Foundation Executive Committee will review your application, and you will be notified after a decision has been made.

Green 4-leaf clover with white "H"'s in each leaf clipart.

The U.S. Department of Agriculture (USDA), Montana State University and Montana State University Extension prohibit discrimination in all of their programs and activities on the basis of race, color, national origin, gender, religion, age, disability, political beliefs, sexual orientation, and marital and family status.