2022 Kansas 4-H and FFA Wheat Variety Plot Enrollment Form (September 2021-September 2022)
For full details about the Wheat Variety Plot Program, visit: http://www.kansas4-h.org/events-activities/conferences-events/wheat/wheat-variety-plots/index.html. There is no fee this year for the five varieties of wheat provided for your plot. Seed companies are again donating the seed to Kansas 4-H.
Please complete all areas for each individual or one entry per group
County/Chapter: ______________________ Agent/Instructor: ____________________
Agent E-mail:_________________________ Office Phone: _______________________
1. Name: ______________________________ Youth birth date: __________Age:______
Address: _____________________________ Phone: ______________________________
City/Zip: _____________________________ Cell Phone: _________________________
Family E-mail:______________________________________________________________
Status: New________ Re-enroll:________
2. Name: ______________________________ Youth birth date: __________Age:______
Address: _____________________________ Phone: ______________________________
City/Zip: _____________________________ Cell Phone: _________________________
Family E-mail:______________________________________________________________
Status: New________ Re-enroll:________
3. Name: ______________________________ Youth birth date: __________Age:______
Address: _____________________________ Phone: ______________________________
City/Zip: _____________________________ Cell Phone: _________________________
Family E-mail:______________________________________________________________
Status: New________ Re-enroll:________
4. Name: ______________________________ Youth birth date: __________Age:______
Address: _____________________________ Phone: ______________________________
City/Zip: _____________________________ Cell Phone: _________________________
Family E-mail:______________________________________________________________
Status: New________ Re-enroll:________
Return by July 23, 2021 to: Deryl E. Waldren
E-mail: [email protected] KS 4-H Wheat Program Coordinator
Phone: 303-349-7403 660 W. 5th St.
Colby, KS 67701
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