Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
-
Area Code
Phone Number
County
Email
example@example.com
Date of Birth
-
Month
-
Day
Year
Date Picker Icon
Name of current High School or College
Intended Major
Situtation
Freshman UIUC
Freshman Parkland Pathways
Sophomore Transfer
Junior Transfer
Parent's Names
Parent's Phone Number
-
Area Code
Phone Number
Parent's Email Address
example@example.com
Please Check the Applicable Box or Boxes
I have 3 or more years of 4-H Club or 4-H Group experience. I have included a letter of recomendation from a 4-H leader or 4-H staff member.
My sister, mother, grandmother, aunt, or other family member lived at 4-H House and I have 3 or more years of leadership experience in a youth organization. I have included a letter of recommendation from a 4-H House Alumnus.
I have 3 or more years of leadership experience in a nationally recognized youth organization. I have included a letter of recommendation from a leader or advisor affiliated with the youth organization.
Please specify dates of leadership experience in 4-H or another nationally recognized youth organization:
2) In a brief summary, please tell about your experiences in 4-H and/or your other nationally recognized youth organizations, and the things you have learned and/or the skills you have gained.
What is your greatest strength and your greatest weakness and why?
Please list any school, community, church, or employment activities and how you plan to use the skills you have gained from these experiences to benefit the house.
Please list any academic achievements.
Autobiography Video
Please record a 3-5-minute video autobiography introducing yourself to the interview committee. Please Include; your planned major, why you are interested in 4-H House, how you reached these choices as well as any other information that will allow us to get to know you better. *Although this is a professional video, we want the chance to get to know you! If you have time, feel free to share about your passions and let your personality shine through!
Submission: When finished with the video autobiography, create a singular Google Drive Folder labeled, Firstname_last_interviewvideo2025. Then share the singular folder with 4hhouseinterview@gmail.com. Please grant us the ability to view and share your video.
References - Three* letters of reference are required, including one from your 4-H leader, 4-H staff member 4-H House alum or youth organization advisor. Please instruct your recommender to send the reference DIRECTLY to the Interview Chair email. Mark the appropriate boxes below indicating the persons you have asked to write your letters. *If you are re-interviewing, only one is required.
County Extension Advisor
High School Principal
Minister
Teacher
4-H Leader
4-H Staff Member
FFA Advisor
4-H House Alum
Other
How did you find out about 4-H House?
Have you visited 4-H House?
Which Interview Weekend do you plan to attend? (March 28th - 29th or April 18th - 19th)
Do you have any food allergies?
Feel free to contact Brynn Boundy at 4hhouseinterview@gmail.com or at (815) 848-3456 with any questions regarding this application, interview weekends, life at the house, or anything else!
*Application deadline is two weeks before your scheduled interview weekend. Please fill out all sections of this application to be considered as an applicant.
Submit
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