Author: darlene

Merced County 4-H Enrollment Update
2014 - 2015
This form must be completed for any member changes to take place in the 4-H computer, enrollment program. This includes adding, deleting, and/or transferring members/projects; changing address, telephone number, school, grade, birth date, and/or projects; and/or adding/changing club rank or office.
This form must be signed by the 4-H organizational leader. This form may be mailed or brought to the 4-H office. A duplicate of this form will be returned to the organizational leader upon receipt.
Club/Group: _________________________________________________________

	Date	Name	Transaction	Waivers	Ins.
1
2
3
4
5
6
7
8
9
10
				Total

Leaders Signature: ___________________________
Date: _________________

	Received by:				Office Use
Date	Signature	Amt. Enclosed		Data Entry

Merced County 4-H Office
2145 Wardrobe Avenue
Merced, CA 95341
(209) 385-7418

(Rev. 11/03)

H:\Pdb\Delivery\Clubs\Admin\New Year\Forms\Enrollment Update Form.pub