Election Judge Form

2013 District 12 4-H Election Convention - Election Judge Application Form

According to the District 12 4-H Election Code, which governs the conduct of the District 12 4-H officer election process and Election Convention, the incumbent Council officers may appoint an election judge. Use this form to submit your application for consideration for one of the three positions.

  • Applicant Information

  • What is your age as of August 31, 2012?
  • Select the county in which you are currently enrolled as a 4-H member.
  • Select the position for which you wish to be considered. The main duties are listed above but may include other duties as well. (You may select more than one).

  • Application Narrative

  • Describe your leadership activities within the 4-H program.
  • Describe your community service activities within the 4-H program.
  • Describe why you are interested in serving in the position(s) you selected above.

  • Confirmation & Verification

  • I verify that all the information I am providing in this application is accurate and that I am willing to travel to the Election Convention to serve as an Election Judge if I am selected. I also certify that I meet all the eligibility requirements as outlined in the District 12 4-H Election Code.

  • NOTICE

    If selected as an Election Judge, you must contact the County Extension Office to register for the event and coordinate payment of any registration fees that may be applicable.
  • Please enter the two words and click on Submit Application. to finalize your submission.