2023-2024 4-H Enrollment Payment Form - Humboldt County

Thank you for being a part of the Humboldt County 4-H Program!

The Humboldt County 4-H Management Team recognizes the dedication of our volunteers. We would like to welcome all volunteers and youth to be a part of the 4-H program. To minimize financial barriers, enrollment fees for youth and/or volunteers will be paid by scholarship from the Humboldt County 4-H Management Team. Please select the scholarship option below if this applies.

✻ = Required

Email Address ✻

Parent/Guardian First Name ✻

Parent/Guardian Last Name ✻

List first and last names of all youth members and/or adult volunteers you are enrolling ✻

Club/Unit ✻

YOUTH ENROLLMENT FEES

Please select one of the two payment options for youth enrollment fees below.

Option 1: Personal Payment for Youth Enrollment Fee:
(click the box and select a quantity)

$72.00 Quantity:

Option 2: If requesting scholarship for youth enrollment fee, please select the number of scholarships.

You are eligible if your annual household income is at or below $50,560.00 and/or your child is eligible for/enrolled in school free or reduced price meal program. (See Reference: https://www.fns.usda.gov/cn/income-eligibility-guidelines, 2023-2024 Federal Poverty guidelines.)

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ADULT VOLUNTEER ENROLLMENT FEES (AKA Club and Project Leaders)

Please select one of the two payment options for volunteer enrollment fees below.

Option 1: Personal Payment of Adult Volunteer Enrollment Fee:
(click the box and select a quantity)

$33.00 Quantity:

Option 2: If requesting scholarship for adult volunteer enrollment fee, please select the number of scholarships.

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If you are paying by credit card, look for the "charge my card" button on the next page.