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SCC UC 4-H Enrollment Fee Survey 2024-25

Thank you for your interest in becoming a

4-H youth member or a 4-H adult volunteer.

This survey is only intended for

4-H program annual enrollment fee payments

for participation July 1, 2024 - June 30, 2025.

Enrollment Fee Payment Instructions
1) Use this survey to indicate your method of enrollment fee payment.

Option#1 - Online payment using this survey to pay by credit card.
Option #2 - Financial Waivers see information in payment section below.

If you have a pre-approved club sponsorship, complete the payment through this payment survey & apply for reimbursement through your club's treasurer. Save the paid receipt you will receive by email and attach it to this reimbursement form to provide directly to your club's treasurer.

What is the Cost?

To enroll in the 4-H program, youth pay $100. per youth and an additional $40. per family. (includes accident and illness insurance for members and enrolled volunteers) Enrollment fees are charged annually and cover one 4-H program year (July 1 - June 30). Fees are not pro-rated for partial year enrollment.

*members and volunteers made active between July 1 - June 30 of a 4-H program year are eligible to participate through December 31. All members and volunteers are required to re-enroll prior to December 1 to continue their participation after Jan 1 of the new year.

Clubs and/or projects may collect additional fees from families or youth to cover the costs of project materials and 4-H events.

UC 4-H programs are open to participants, regardless of their ability to pay. Program Enrollment fees will be waived or reduced for eligible youth. To request a "Fee Waiver" please indicate your need below.

More questions?
Contact the 4-H Youth Development Program Office,

University of California Cooperative Extension, Santa Clara County zmahmood@ucanr.edu

✻ = Required

Payor Information

*****STOP*****

Do not complete your payment until after you have updated your ZSuite enrollment.

NEW 4-H Youth Enrollment Information

Returning 4-H Youth Enrollment Information

NEW Volunteer Requirements

Returning Volunteer Requirements

Email used in ZSuite: ✻

Family Name used in ZSuite: ✻

Primary 4-H Club Membership Information: The same "primary" club (unit) should be selected in ZSuite.

What is the primary Santa Clara County UC 4-H Club (Unit) you will enroll in? ✻

Adams 4-H (Gilroy) El Sereno 4-H (Campbell, Saratoga, Los Gatos) Homesteaders 4-H (Santa Clara, Sunnyvale) Pacheco Pass 4-H (San Martin/Gilroy) Pleasant Acres 4-H (Berryessa, Milpitas, San Jose) Rolling Hills 4-H (Cupertino, Los Altos, M.View) San Martin 4-H (Morgan Hill, San Martin) Sunset 4-H (Blossom Hill, Martial Cottle Park)

**** no t-shirts remain for distribution**********

t-shirts were distributed to the first members and volunteers who enrolled for the 2024/25 4-H program year.

Youth Large - Youth Extra Large Adult Small - ALL GONE Adult Medium - ALL GONE Adult Large - ALL GONE Adult Extra Large Adult 2X - ALL GONE

YOUTH MEMBERS ENROLLING FOR 2024-2025 PROGRAM YEAR

List all youth members you are paying enrollment fees for:

Please use the format shown below.

(1) Child's FIRST AND LAST name

(2) Child's FIRST AND LAST name

Or type "none." ✻

ADULT VOLUNTEERS ENROLLING FOR 2024-2025

4-H PROGRAM YEAR

In your household, are there adult volunteers planning to complete the enrollment requirements for the 2024-2025 program year?

Returning Adult Volunteer Requirements

NEWLY enrolling Adult Volunteer Requirements

IF YES, PLEASE COMPLETE THE NEXT SECTION.

*Volunteer enrollment is not required for your child to participate.

Do Not complete this section unless you plan to

become a certified 4-H Volunteer.

Please list the names of any adult in your household

who WILL complete the necessary steps

Please use the format shown below.

(1) Adult's name

(2) Adult's name

Or type "none." ✻

Payments made for 4-H enrollment are non-refundable.

Payments made in error may be refundable if the 4-H office is contacted within 7 days of the payment error.

Payment Option #1

If paying any enrollment fees in full by credit card,

please indicate the number of youth members and

family fees you are paying for in this section.

Do not complete option #2 for adults.

CHECK BOX AND CHOOSE the # OF YOUTH MEMBERS you will pay for by credit card for the 2024-2025 4-H Program year.

How many youths are you enrolling? Choose the quantity.

If no youth enrolling from this household, do not check box.

(Annual youth enrollment is $100.00)

$100.00 Quantity:

CHECK BOX to pay the required one-per family annual fee* by credit card for the 2024-2025 4-H Program year.

One family fee shall be paid per family per year in addition to youth fees. If only an adult volunteer is enrolling, only the family fee is paid.

$40.00

Payment Option #2

If applying for a need based youth fee waiver, or a partial youth fee waiver, please complete ONLY option #2, A & B below.

Option #2 - Part A: ONLY complete this section if you are applying for a need based partial or full youth fee waiver.

UC 4-H programs are open to participants, regardless of their ability to pay. Program Enrollment fees will be waived or reduced for eligible youth determined to be eligible*. To request a "Fee Waiver" please indicate your need below. Provisions will be made by the 4-H club/unit or county council to cover program fees for eligible youth who are unable to pay them.

The parent/guardian of an eligible youth for which a program fee waiver or reduction is requested *attests that the child(ren) included in this request is(are) eligible.

*To determine eligibility for a waiver or reduction of the program fee:

The annual household cash income is at or below $50,560.

FAQ about fee waivers

UC reserves the right to verify the above information by further reviewing the household financial status with the parent/guardian.

If you have additional circumstances you wish to have considered, please email Zubia Mahmood, zmahmood@ucanr.edu

Need-based fee waivers are offered to youth only.

I am applying for a waiver of the $40. family fee (youth only) I am applying for a $50 youth fee waiver per youth I am applying for a full fee youth waiver per youth

Option #2 - Part B: If you are applying for a youth fee waiver, please indicate the amount you will pay at this time, by credit card, in this section.

Youth member with $50. fee waiver, will pay $50.

Youth member with full fee waiver, will pay nothing at this time.

Fee waiver applicants will be contacted if any additional information is needed.

On the next screen, you will begin the process for entering your credit card information.

If you have not entered any enrollment payments, the next page will show zero.

If you are having trouble with credit card processing, please view this Credit Card Processing Help Guide.

Activation of youth enrollments may take up to 48 hours (not including holidays & weekends).

Note: Returning adult enrollments are made active when the required Campus Extension training is completed.

Additionally, for new volunteers, enrollment becomes active after all enrollment steps are completed and the Live Scan has been cleared by DOJ and approved by the UCCE County Director.