Applicants are responsible to submit this form, an essay, and a current year record book
(after Club General Leader has reviewed it) to the Extension Racine County office at
1072 Milwaukee Avenue, Burlington, WI 53105 on weekdays between 9:00 a.m.-12:00 p.m. or 1:00-4:00 p.m. Submissions can be turned in, placed in the green drop box in front of the Extension Racine County Office, or received via USPS mail by Thursday, September 15th 2022 at 4:00 p.m. Late application materials will not be accepted. Please be sure that you have won the required ribbons and awards for your program category.