STATE OFFICER FORM
NOMINATION OF STATE 4-H OFFICERS

A 4-H member is eligible to run for State 4-H Office if he or she is at least 16 years of age as of January 1 of the year of nomination, and if he or she has been an active 4-H member for at least three years prior to seeking office.

A 4-H member desiring to see a State 4-H Council Office must complete this form, attach a recent black and white glossy photo and submit it to the State 4-H Office: Shannon B. McCollum, Extension 4-H Assistant Box 7606 NCSU Raleigh, NC 27695-7606, so that it is postmarked on or before JUNE 15 of the current year. To finalize candidacy, a second copy of this form should be submitted to the State 4-H Council President at the State 4-H Council meeting held on Monday of North Carolina 4-H Congress and candidates should also be nominated verbally for the office they seek to hold. If for any reason, no candidate is nominated for a particular office, that office will be reopened and nominations fro the reopened office will be accepted at the State 4-H Council Meeting.

Name ____________________ County ____________________

Address ______________________________________________________

Age ____________________ Years in 4-H ____________________

Telephone Number ____________________ Race ____________________

Nomination for (Check one):

___ Pres. (Boy-Even Year, Girl-Odd Year)	___ Vice-Pres. (Girl-Even Year, Boy-Odd Year)
___ Sec/Treas. (Girl-Even Year, Boy-Odd Year)	___ Reporter (Boy-Even Year, Girl-Odd Year)

PARENTAL INFORMATION:

Father's Name ____________________   Address ____________________

Mother's Name ____________________   Address ____________________

Major Qualifications (briefly):

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COMMENT BY EXTENSION AGENT: It is your honest opinion that this member can preside and properly execute the responsibilities of the State office that he/she seeks? Why?

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SIGNATURE OF NOMINEE ____________________________

SIGNATURES: Approved by Extension Agents

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Last updated Nov 12, 2004

August 29, 2008