Applicants are responsible to submit this form, an essay, and a current year record book to the

Extension Racine County office at 1072 Milwaukee Avenue, Burlington, WI 53105.

All three items must be submitted together at one time. (Please contact your club leader if you need your record book returned so you can apply for this award.) The applicant’s photo should then be emailed to elizabeth.vazquez@wisc.edu.
Submissions can be turned in or placed in the green drop box in front of the Extension Racine County Office, by Wednesday, September 27, 2023. Late application materials will not be accepted.