Emerald Clover

Michigan 4-H Foundation
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Emerald Clover Nomination Form

  • (Note: Three years of documented Michigan 4-H membership is required in order for nominee to be considered.)
  • Nominee’s current mailing address:

    (Note: This is required in order for a nominee to be considered. Nominees must be living and we must be able to contact them if they are chosen to receive this honor.)
  • Evidence of professional/business achievement and success

  • (5 points)
  • (5 points)
  • (5 points)
  • Evidence of community service/philanthropy leadership

  • (5 points)
  • (5 points)
  • (5 points)
  • Evidence of leadership in community, state and national affairs

  • (5 points)
  • (5 points)
  • Evidence of leadership or achievement as a 4-H member/volunteer

  • List awards, recognition, leadership and achievements: (5 points)
  • List awards, recognition, leadership and achievements. (5 points)
  • Who might also be contacted to share information about why this person should receive this recognition?

  • This information is requested so that we may provide notify you on the outcome of your nomination. Thank you.