County Fund Request Form

County*
Fund Name:*
Amount Requested*
List the amount requested from your county/endowment fund. Note you may only request up to the allocated spending amount available for the fiscal year.
Summary of how the funds will be used*
Contact
4-H/CYI Staff Name*
Your name
4-H/CYI Staff Title*
Your title (4-H Program Coordinator, 4-H Supervising Educator, etc.)
4-H/CYI Staff Email*
Your email
Phone
Your phone (provide the best number to reach you at)
4-H/CYI Supervisor Name*
Supervising Educator, CYI Leadership, etc.
Supervisor Title*
4-H/CYI Supervisor Email*
By submitting this form, I understand that spending should be completed by June 30 and acknowledge that expenditures must be in accordance to the fund agreement as specified by the donor. Please contact the Michigan 4-H Foundation if you have any questions regarding your fund.
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