The Ambassadorapplicationformshould Be Completed by Theuseof a Computer

OKLAHOMA4-H

State4-HAmbassadorApplication

▪The AmbassadorApplicationFormshould be completed by theuseof a computer.

▪Applicationsmust be submittedbothelectronically andhardcopy throughthemail.

▪Electronicapplicationsmust be submittedby 11:59 p.m. March15th, 2018and thehard

copymust bepostmarked on or before March15th.Anelectronic copyandone hard copyoftheapplication must both bereceived.

▪Electroniccopy of application (completedthroughQuestion 6) shouldbeemailed to

oudo not need toelectronically sendCertification Form,Reference Sheets, Lettersof Recommendationorhave electronic signatures.All of theseitems should beincludedin your hard copymailing.

▪Hard copiesshould be mailedto:

OklahomaState4-HOfficeAttn:CathyAllen

2054-H Youth Development Bldg.Stillwater,OK74078

PersonalInformation:

Name:

Male

Female

Emailaddress:

County:Club:

District:

Home address: (includingZip Code)

PhoneNumber:Cell PhoneNumber:DateofBirth:

Yearsin4-H:

GradelevelinSchool:MonthYear of High School Graduation:

Answersshouldconveyyourdedicationto4-H,yourleadershipskillsandyourabilitytocommunicatewhat4-Hisanditsvaluetothecommunity.

1.Major4-Hprojectarea(s) andnumberofyearsineach.

2.4-HOfficesheld,major 4-Hcommitteeworkcompletedandprogramscoordinated.

3.Describeyourexperiencesincommunicating(bothoralandwritten)topublicaudiences.Demonstrateyourabilitytocommunicateeffectivelywithpublicaudiences.(100-300 words)

4.Describeexperiencesyouhavehadinworkingwith4-H donors,publicofficials,etc.

Demonstrateyourabilitytorelateto4-H donorsandelectedofficials.(100-300words)

5.DescribewhyyouwanttobeaState4-H Ambassador?(100-300words)

6.Describeateamworkexperienceyouwereinvolvedin.Whatweretheteamwork challengesandhowdidyouovercomethem?Demonstrateyourabilitytoworkina groupofyouthandadults,communicateeffectively,overcomeconflict,and compromise.(100-300 words)

CertificationForm

TheCertificationFormistobecompletedandsignedbyyouandyourparent,clubleaderandcountyExtensioneducator.

LettersofReferenceandReferenceSheet

Eachofthereferenceslistedbelowshould completealetterofrecommendationandonecopyofthereferencesheetfollowing.Theletterandreference sheetsshouldbeplacedinasealedenvelopebyyourreferencewiththereference’ssignatureacrosstheseal of theenvelope.The sealed and signed envelopewillbeopenedbytheState4-HOffice.

LettersshouldbefromyourcountyExtension educator,parent and a non-familymember.

Listthenameandcompleteaddressofreferencesbelow:

CountyExtensionEducatorEmailAddressPhone

Parent(s)orGuardianEmailAddressPhone

PersonotherthanfamilyEmailAddressPhone

Ihavereviewedtheobjectives,rolesandfunctions,andexpectationsofaState4-HAmbassador.Iamwillingtodevotethetimeandtravelrequired.

IwillbeactiveinmyClubandCounty 4-HProgram,aswellasmaintainan acceptableacademicstandardinschoolduringmyserviceasaState4-HAmbassador.

IfselectedasaState4-H Ambassador,Iamwillingtopayorsecureasponsorfortheinitialfinancialrequirementofapproximately$60.00tocoveraportionofthe costofthejacket,crest,tienamebadgeandLeadershipTeampolo.IwillvisitwithcountyExtensionstaffbeforemakingdonorcontacts.

Further,IamwillingtoconductmyselfinthehigheststandardsexpectedofaState4-HAmbassador.

Applicant’ssignature:______

PLEASEPRINT:

Name: ______

Address: ______

County: ______

Weunderstandthatour(my)son/daughterwishestoserveasanOklahomaState4-HAmbassador.We(I)willsupporthim/herinfulfillingtheresponsibilitiesshouldhe/shebe selected.We(I)havewrittenareferenceletterandhavecompletedareferencesheet.

Parent/GuardianSignature: ______

Wecertifythattheabovenamed 4-H’erisenrolled,activeandingoodstandinginourclubandcounty4-Hprogram.Wesupporthis/herapplicationforthepositionofState4-HAmbassador.

4-HClubLeaderSignature: ______

CountyExtensionEducatorSignature: ______

NOTE:Tobecompletedbyeachofthethreeindividualswhosubmitlettersofreference.NameofApplicant: ______

Checktheappropriatespacesindicatingyourappraisalofthepersonalcharacteristicsoftheapplicant. Theinformationreceivedwillbeconfidentialandwillbereviewedbytheselectioncommitteeonly.

Pleasereturnthisform,alongwithyourletterofreference,inasealedenvelopewithyoursignatureacrossthesealtothe4-HAmbassadorapplicant.Theapplicantwillincludeyoursealedenvelopeintheirapplicationsubmission packet.TheapplicationmustbepostmarkedonorbeforeMarch15,2018.

Characteristic / Outstanding / Desirable / Undesirable / Unknown
TEAMWORK
Demonstratedabilitytoplacecommitmenttogroupgoalsoverpersonalaspirations.
RELIABILITY
Faithfulnesstoduties;personalintegrity;senseofresponsibility.
PUNCTUALITY
Ontimeandpreparedforappointmentsandmeetings.
LEADERSHIP
Initiative;abilitytoinspireotherstoact.
INDUSTRY
Concentrationofefforttoatask.
COMPETENCE
Abilitytorepresent4-Hinformalandinformalsettings.
CREATIVITY
Originalandimaginative.
APPEARANCE
Cleanliness;dress;poise.
EXPRESSION
Effectivenessandfluencyinspeaking.
Effectivenessandfluencyinwriting.
Abilitytomeetpeople.
Senseofhumor.
Tact.
Self-confidence.
COMMITMENTTO4-H
Thisprogramismorethananhonor;itrequiresbothserviceandsacrifice.

Referencesubmittedby:

DateSignatureOccupationorTitle