Clover Buddies Poultry Entry Form Information Name: _________________________________________________________________ Address: _______________________________________________________________ City: __________________________________ Zip: _________________________ Phone: (712)___________________________________ Age_________ Birthdate_____________ Last grade completed __________________ Parent/Guardian Name: _____________________________________________ Are you in 4-H? Yes______ No Are you in Clover Kids? Yes _____ No _____ Animal Information Breed of Bird Age of Bird Sex (Male or Female) Name if it has one Due July 13, 2018 at the Extension and Outreach Office
Clover Buddies Poultry Entry Form Information Name: _________________________________________________________________ Address: _______________________________________________________________ City: __________________________________ Zip: _________________________ Phone: (712)___________________________________ Age_________ Birthdate_____________ Last grade completed __________________ Parent/Guardian Name: _____________________________________________ Are you in 4-H? Yes______ No Are you in Clover Kids? Yes _____ No _____ Animal Information Breed of Bird Age of Bird Sex (Male or Female) Name if it has one Due July 13, 2018 at the Extension and Outreach Office
Clover%20Buddies%20Poultry%20Entry%20Form.docx