Georgia 4-H Enrollment V2
 

Enroll in Georgia 4-H -- Murray County

Please Select your School and Club. Then fill out all of the appropriate information..

Student Information
* required CLUB_NAME:
* required SCHOOL_NAME:
* required GRADE:
* required FIRST_NAME:
* required LAST_NAME:
PREFERRED_NAME:
ADDRESS_1:
CITY:
STATE:
ZIP:
* required DATE_OF_BIRTH:
* required GENDER:
EMAIL:
CELL_PHONE:
  Race and Ethnicity (check all that apply) (optional)
  White
  Black or African American
  American Indian or Alaska Native
  Asian
  Native Hawaiian or Other Pacific Islander
  Hispanic or Latino
 

 

Other Information

  Are you a member of a military family?
(Please select this box if you have a parent or legal guardian
who is actively serving in any branch of the military.)
* required Select your residence
Parent 1 Information
FIRST_NAME:
LAST_NAME:
ADDRESS_1:
CITY:
STATE:
ZIP:
GENDER:
CELL PHONE:
RELATIONSHIP to Student:
Enter text from the image to the right:
   
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The University of Georgia and Ft. Valley State University, the U.S. Department of Agriculture and counties of the state cooperating. The Cooperative Extension Service offers educational programs, assistance and materials to all people without regard to race, color, national origin, age, sex or disability. An equal opportunity/affirmative action organization committed to a diverse work force.