Thank you for your interest in becoming a

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

in San Mateo / SF County.

This survey is only intended for

4-H program annual enrollment fee payments

for participation July 1, 2025 - June 30, 2026.

STOP

---- Before completing your enrollment payment ----

Please update and submit your household's 4-H enrollment profile on

Z Suite

A ZSuite enrollment must be "Pending Approval" and the payment survey must be completed befor we can make an enrollment active.

**DO NOT** create a new profile if you have been enrolled at any time prior to July 2025.

New Members (never enrolled in 4-H)

New families will create a new household profile in the ZSuite system.

ONLY create an Adult Volunteer profile if you intend to also complete the requirements to become a certified 4-H volunteer. NEW Adult Requirements / RETURNING Adult Requirements

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 - Youth Financial Waivers see information in payment section below.

What is the Cost?

To enroll in the 4-H program, youth pay $100., Adult Volunteers pay $30. (includes accident and illness insurance) 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.
*Returning members and volunteers are required to re-enroll before October 31 to continue their participation in 4-H projects and activities 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.

More questions?

Contact the 4-H Youth Development Program Office,
T'Nay Pham, tnypham@ucanr.edu

University of California Cooperative Extension, San Mateo/SF Counties

✻ = Required

Payor Information

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 4-H Club (Unit) you will enroll in? ✻

Belmont 4-H Burlingame-San Mateo 4-H Cañada/Redwood City 4-H Half Moon Bay 4-H Pacifica 4-H San Bruno/South San Francisco 4-H San Carlos/Eaton Hills 4-H Jones Gulch 4-H Summer Camp - see note above

YOUTH MEMBERS ENROLLING FOR 2025-2026 PROGRAM YEAR

List all youth members you are paying enrollment fees for, first and last name

Or type "none." ✻

ADULT VOLUNTEERS ENROLLING FOR 2025-2026

4-H PROGRAM YEAR

In your household, are there adult volunteers enrolling* for the 2025-2026 program year?

*New Volunteer enrollment requires a Live Scan fingerprinting, online training, and a fee.

IF YES, PLEASE COMPLETE THE NEXT SECTION.

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

Returning Adult Volunteer Requirements

NEWLY enrolling Adult Volunteer Requirements

Please list the names of any adult in your household

who will complete the necessary steps to serve as a 4-H Adult Volunteer for the 2025-26 program year.

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

All 4-H enrollment fees are to paid in full by credit card.

Please indicate the number of youth members and

4-H Adult Volunteers you are paying for in this section.

Do not complete option #2

CHECK BOX AND CHOOSE the # OF YOUTH MEMBERS you will pay for by credit card for the 2025-2026 4-H Program year.

How many youths are you enrolling? Choose the quantity.

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

(Annual youth enrollment is $100.00)

$100.00 Quantity:

CHECK BOX AND CHOOSE the # OF Adult Volunteers who will complete their training and you will pay for by credit card for the 2025-2026 4-H Program year. Adult fee waivers may be reimbursed by your 4-H club. Check with your club treasurer.

(Adult Volunteers, annual enrollment is $30. per adult)

$30.00 Quantity:

Payment Option #2

Do not complete this section if you have paid in section #1

Application for a need based YOUTH fee waiver, or a partial youth fee waiver. Fee waivers are provided for YOUTH only.

please complete ONLY option #2, A & B below.

PLEASE READ THOROUGHLY BEFORE CHOOSING THIS OPTION

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 Brenda Vales, bcvales@ucanr.edu

Need-based fee waivers are offered to youth only.

Option #2 - Part A: ONLY complete this section if you have read and agree to eligibility requirements and are applying for a partial or full need-based youth fee waiver.

Fee waivers are available for youth only. Fee waivers are subject to review and approval by the 4-H office.

I am not applying for a need-based fee waiver. I am applying for a need-based $50 youth fee waiver per youth I am applying for a need-based $100 youth fee waiver per youth

Option #2 - Part B: If you are applying for an *eligible 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 weekends).

Note: Adult 4-H Volunteer enrollments are made active when the required Volunteer Enrollment steps are completed. If you do not plan to complete the adult volunteer enrollment screening and training, DO Not pay for adult enrollments, and DO Not add the name of an adult above.

2. SM/SF UC 4-H Enrollment Fee Survey 2025/26