The designated and authorized 4-H delegate from the county will bring this completed form
to the election. This delegate will cast the vote upon roll call, remain until balloting is
completed and turn in the ballot to the Chairman of Elections.
This is to certify that ___________________________________ has been authorized to cast
___________________________ County's _________________________ electoral votes
in the election of state officers.
You will determine your own vote by your total 4-H membership in organized Community 4-H Clubs and Special Interest Youth Groups, which you reported on your Annual Report.
Indicate below in the designated block the preferential rating and the number of votes cast by
the 4-H County Council for each candidate. Please type in all candidates for each office.
Bring two (2) copies.
For President
For Vice-President
Candidates
Preferential Rating
Votes for each
Candidates
Preferential Rating
Votes for each
For Secretary-Treasurer
For Reporter
Candidates
Preferential Rating
Votes for each
Candidates
Preferential Rating
Votes for each
SIGNATURES:
_______________________________________ (President, County 4-H Council)
