National 4-H Dairy Youth Conference
(Please print or type)
Age as of January 1, 2010:
(Note: You must be at least 15 but not more than 18 years of age as of January 1, 2010 to be considered for this conference)
Telephone Number: ( )
Social Security Number:
Name and telephone number of your 4-H agent:
Please answer the following 6 questions fully and in your own words. You may attach additional pages.
1. Are you enrolled as a 4-H member in North Carolina? Yes No
2. How many years have you participated in dairy youth activities?
3. List all of the dairy and dairy youth activities in which you have participated.
4. Describe what you think the dairy industry in North Carolina will be like in 10 years.
5. Describe your future educational and career plans.
6. Why would you like to be selected to attend the National Dairy Youth Conference?
Please send this completed application by June 1, 2010 to:
Dr. Brinton Hopkins
Department of Animal Science
116 Polk Hall
North Carolina State University
Raleigh, NC 27695-7621
or by fax:
Department of Animal Science, NCSU