2026-27 4-H Interest Survey

4-H Program Year Interest Survey

Help us plan for the upcoming 4-H program year by sharing your child's interests and contact information.

Parent / Guardian First Name*

Parent / Guardian Last Name*

Email Address*

Please use the email that you check most frequently.

Phone Number*

Please double check for accuracy as this will be used as a contact method.

Child First Name*

Child Last Name*

Child Age*

Grade*

Which clubs is your child interested in joining? (Select all that apply)*

ALivestock

BHorse Club

CCooking

DShooting Sports

EPhotography

FTeens

GBuzz and Bloom

HSewing

ICloverbuds

Are there any additional 4-H clubs that Nicholas County 4-H does not currently offer that you feel there would be enough interest to start?*

By signing below, I understand that submitting this form DOES NOT enroll my child in 4-H. To participate in a 4-H club, my child must be officially enrolled through 4-H Online beginning September 1. Club spaces are limited and will be filled on a first-come, first-served basis, based on required youth-to-adult supervision ratios and the number of agents and approved volunteers available.

Signature*

Draw Type Upload

Choose your signature image

Your form has been saved. You can complete it using this link within %(day)s days.