Westchester County 4-H Animal Identification Certificate and ...
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Westchester County 4-H Animal Identification Certificate and Project Animal D eclaration Animal’s Ow ner Information N am e: _________________________________________________________________ Ad d ress: _______________________________________________________________ Phone N um ber: _________________________________________________________ Signature: ______________________________________ Date: _______________ N ame of youth participant _____________________________________________ Clubs utilizing the sam e anim al for m ultiple m em bers m ay list the Club’s N am e as the Youth Participant here. Details for each youth are entered on next page. Animal’s Information N am e/ ID# of Anim al: ___________________________________________________ Anim al’s Birthd ate (or approxim ate age): __________________ Species/ Breed : __________________________________________________________ Id entifications (tattoos, eartags, ear notches, etc): ____________________________ ________________________________________________________________________ For rabbits, d ogs, poultry and sm all anim als, p lease attach clear color photos of your anim al. Com puter printed photos are acceptable. For your convenience you m ay e-m ail photos to nm [email protected] u - label subject as ‘‘Fair Anim al Photo’’.
Building Strong and V ibrant N ew Y ork Communities Cornell Cooperative Extension is an employer and educator recognized for valuing AA/EEO, Protected Veterans, and Individuals with Disabilities and provides equal program and employment opportunities. Please contact CCE of Westchester if you have any special needs.
Youth’s Information N am e: ________________________________
Age (on Jan 1st) _______________
Ad d ress: _______________________________________________________________ Phone N um ber: _______________________(cell)____________________________ Signature: ______________________________________ Date: _________________
By signing here you declare that the animal listed on this form w ill be cared for by the youth and is officially designated as his/her 4-H Project Animal as of June 1 of the current year.
Parent/Guardian Information N am e: _________________________________________________________________ Ad d ress: _______________________________________________________________ Phone N um ber: _______________________ (cell)_____________________________ Signature: ______________________________________ Date: _________________
4-H Lead er’s Signature ___________________________ Date: _________________
4-H Ed ucator’s Signature: _________________________ Date: _________________
This form must be completely filled out and on file w ith Cornell Cooperative Extension of Westchester County in order for youth to be eligible to exhibit animals at the Putnam County 4-H Fair, the Westchester 4-H Show case, the N ew York State Fair 4-H youth animal classes, and if you are bringing your project animal to the Yorktow n Grange Fair.
Westchester County 4-H Animal Identification Certificate and Project Animal D eclaration Animal’s Ow ner Information N am e: _________________________________________________________________ Ad d ress: _______________________________________________________________ Phone N um ber: _________________________________________________________ Signature: ______________________________________ Date: _______________ N ame of youth participant _____________________________________________ Clubs utilizing the sam e anim al for m ultiple m em bers m ay list the Club’s N am e as the Youth Participant here. Details for each youth are entered on next page. Animal’s Information N am e/ ID# of Anim al: ___________________________________________________ Anim al’s Birthd ate (or approxim ate age): __________________ Species/ Breed : __________________________________________________________ Id entifications (tattoos, eartags, ear notches, etc): ____________________________ ________________________________________________________________________ For rabbits, d ogs, poultry and sm all anim als, p lease attach clear color photos of your anim al. Com puter printed photos are acceptable. For your convenience you m ay e-m ail photos to nm [email protected] u - label subject as ‘‘Fair Anim al Photo’’.
Building Strong and V ibrant N ew Y ork Communities Cornell Cooperative Extension is an employer and educator recognized for valuing AA/EEO, Protected Veterans, and Individuals with Disabilities and provides equal program and employment opportunities. Please contact CCE of Westchester if you have any special needs.
Youth’s Information N am e: ________________________________
Age (on Jan 1st) _______________
Ad d ress: _______________________________________________________________ Phone N um ber: _______________________(cell)____________________________ Signature: ______________________________________ Date: _________________
By signing here you declare that the animal listed on this form w ill be cared for by the youth and is officially designated as his/her 4-H Project Animal as of June 1 of the current year.
Parent/Guardian Information N am e: _________________________________________________________________ Ad d ress: _______________________________________________________________ Phone N um ber: _______________________ (cell)_____________________________ Signature: ______________________________________ Date: _________________
4-H Lead er’s Signature ___________________________ Date: _________________
4-H Ed ucator’s Signature: _________________________ Date: _________________
This form must be completely filled out and on file w ith Cornell Cooperative Extension of Westchester County in order for youth to be eligible to exhibit animals at the Putnam County 4-H Fair, the Westchester 4-H Show case, the N ew York State Fair 4-H youth animal classes, and if you are bringing your project animal to the Yorktow n Grange Fair.
