IL 4-H Alumni Association Registration
4-H members, alumni and volunteers share a rich history. We want to keep you connected to the Illinois 4-H program. Thank you for registering as a member of the Illinois 4-H Alumni Association
Name
First Name
Last Name
Maiden Name (if applicable):
Birthdate
Gender
Male
Female
Other
Race
White
Black
Native American or Pacific Islander
Asian
Other Race
2 or more races
Unknown
Ethnicity
Hispanic/Latino
Non-Hisanic/Non-Latino
County & State of 4-H Membership: (e.g. "Macon, IL")
What decades were you involved in the 4-H program as a youth? Mark all that apply. (We are seeking history)
1940's
1950's
1960's
1970's
1980's
1990's
2000's
2010's
2020's
Other
Email Address:
example@example.com
Cell Phone Number:
Please enter a valid phone number.
Home Phone:
Please enter a valid phone number.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Employer Business Name:
Job Title:
I am a:
4-H Alumni
4-H Volunteer
Friend of 4-H
I would be interested in:
Volunteer in a local county.
Volunteering at the state level.
Sharing about my career experience.
Other
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