Nomination Form

This form can be used to nominate someone for one of these awards.

•	 Leader of the Year
•	 Friend of 4-H			
•	 All Star Award

NAME OF PERSON/BUSINESS/ORGANIZATION___________________________________

ADDRESS____________________________________________________________________

CITY/STATE/ZIP_______________________________________________________________
											

PHONE______________________________________

NOMINATOR AND PHONE #____________________________________________________

List significant contributions to Ingham County 4-H or club efforts.