4-H Youth Interest Survey

4-H is an organization that can help you learn about things that interest you in fun and exciting ways. It also allows you to make friends and work with others.

To help us plan for 4-H clubs in your community, we need your ideas. Please check the
topics listed below that you would like to learn about. Select up to four areas.

o Animals
o Sewing
o Engine Repair
o Public Speaking
o Gardening
o Child Care
o Household Pets
o Computers
o Leadership
o Wildlife
o Life in other Countries
o Cooking
o Nutrition
o Photography
o Art
o Rocket building

Would you like to become a 4-H member?     Yes o       No  o

List your hobbies _____________________________________________________

___________________________________________________________________

Name _____________________________________________________________

Birthdate __________________________

Address  ___________________________________________________________

School _____________________________________________________________

Telephone __________________________________________________________

Name of Parent(s) ____________________________________________________