____ Campfire ____ Theatrical Production ____ School/Co-Op Club Member Member ____ Officer/Volunteer for a ____ Sports Team (Member/Coach) ____ Grange Non-4-H Group/Activity ____ Student Council Member ____ Honor Roll ____ Other __________________ ____ Music ____ Part-Time Job (Choir/Band Member)
____ Campfire Member ____ Grange ____ Honor Roll ____ Music (Choir/Band Member) ____ Theatrical Production ____ Officer/Volunteer for a Non-4-H Group/Activity ____ Other __________________ ____ Part-Time Job ____ School/Co-Op Club Member ____ Sports Team (Member/Coach) ____ Student Council Member