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    4-H Enrollment Form

    Uploaded by

    Michael Abanes
    This document is an enrollment form for 4-H Clubs in the Philippines to register with the Federation of 4-H Clubs in Eastern Visayas. The form requests information about the club such as its name, address, membership numbers, and leadership. It also lists the requirements for registration which include directories of officers and members, and an endorsement from the appropriate local authority. Clubs must submit hard copies to the local agriculture office and electronic copies by email or Google Form to receive a unique registration number. Signing the form signifies the club's agreement to abide by the Federation's policies and consent for their information to be published and shared.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd

    4-H Enrollment Form

    Uploaded by

    Michael Abanes
    146 views2 pages
    This document is an enrollment form for 4-H Clubs in the Philippines to register with the Federation of 4-H Clubs in Eastern Visayas. The form requests information about the club such as its name, address, membership numbers, and leadership. It also lists the requirements for registration which include directories of officers and members, and an endorsement from the appropriate local authority. Clubs must submit hard copies to the local agriculture office and electronic copies by email or Google Form to receive a unique registration number. Signing the form signifies the club's agreement to abide by the Federation's policies and consent for their information to be published and shared.

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    This document is an enrollment form for 4-H Clubs in the Philippines to register with the Federation of 4-H Clubs in Eastern Visayas. The form requests information about the club such as its name, address, membership numbers, and leadership. It also lists the requirements for registration which include directories of officers and members, and an endorsement from the appropriate local authority. Clubs must submit hard copies to the local agriculture office and electronic copies by email or Google Form to receive a unique registration number. Signing the form signifies the club's agreement to abide by the Federation's policies and consent for their information to be published and shared.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    146 views2 pages

    4-H Enrollment Form

    Uploaded by

    Michael Abanes
    This document is an enrollment form for 4-H Clubs in the Philippines to register with the Federation of 4-H Clubs in Eastern Visayas. The form requests information about the club such as its name, address, membership numbers, and leadership. It also lists the requirements for registration which include directories of officers and members, and an endorsement from the appropriate local authority. Clubs must submit hard copies to the local agriculture office and electronic copies by email or Google Form to receive a unique registration number. Signing the form signifies the club's agreement to abide by the Federation's policies and consent for their information to be published and shared.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    You are on page 1of 2

    FEDERATION OF 4-H CLUB (RURAL YOUTH) OF THE PHILIPPINES, INC.

    4-H Club in Eastern Visayas


    Palo, Leyte

    ENROLLMENT FORM

    CLUB PROFILE
    Name of Club

    Club’s Address

    Street/Purok Barangay Municipality/City Province


    Classification Official Contact Number/s

    School-based
    Community-based Official E-mail Address

    Current Number of Registered Members Date of Establishment of Club

    LEADERSHIP AND MEMBERSHIP INFORMATION


    Name of President of Club Name of Adviser

    Last Given Middle Last Given Middle


    Mobile Number Mobile Number

    E-mail Address E-mail Address

    ATTACHMENTS / REQUIREMENTS
    This Official Registration Form shall be accompanied by the following:
    (Please check tip box if complied)

    DIRECTORY OF OFFICERS AND ADVISERS


    LIST OF MEMBERS IN GOOD STANDING
    ENDORSEMENT/CERTIFICATION FROM APPROPRIATE AUTHORITY
    ( ) For school-based 4-H clubs: Certificate of Recognition from a competent school
    authority supervising student affairs;
    ( ) For community-based 4-H clubs: Certificate of Recognition from the Barangay
    or municipal/city agriculture office where the club is established.

    4-H Club Enrollment Form | Page 1


    SUBMISSION OF REQUIREMENTS
    The documentary requirements of registering 4-H Clubs shall be submitted
    to the appropriate office:

    (a) Hardcopies to the Municipal or City Agriculture Office where the club is established for
    verification; and
    (b) Electronic/ Scanned copies to the 4-H Club in Eastern Visayas Federation’s email
    address 4hclub8@gmail.com or Google Form link provided for the issuance of the
    Unique Registration Number (URN).

    UNDERTAKING
    We hereby signify our desire to seek registration with the 4-H Club in Eastern Visayas
    . For this reason, we hereby undertake to swear that:

    (1) The information contained herein and the attachments are true and correct;
    (2) We consent that the information supplied in this Application for Registration be posted
    online or printed as part of the official list of registered and verified clubs to be
    published by the 4-H Club in Eastern Visayas Federation;
    (3) We have read and understood in full the Policy Guidelines in the Registration of 4-H
    Clubs in Eastern Visayas, and agree to abide by its provisions;
    (4) Should the organization commit any violation of the Philippine Constitution or laws of
    the land or rules and regulations of duly constituted authorities and/or violation to any
    policy, resolution, or rules and regulations of the 4-H Club in Eastern Visayas
    Federation, our registration may be suspended or revoked.

    We, the undersigned, expressly authorize the 4-H Club in Eastern Visayas or its
    representatives to use, share and process personal information that we have provided,
    shared or declared in this form/document for any lawful purpose.

    _____________________________ ___________________________
    4-H Club President Adviser
    (Print and Signature) (Print and Signature)

    Date of Filing: ____________________

    4-H Club Enrollment Form | Page 2

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