Please complete the recruiting delegate report form and submit it with your recruiting winner delegate form for registration to 4-H Electric Congress. All forms are due by April 15th, along with your county's delegation information. Please print or type your information on these forms.

Recruiting____________ Recruiting AT LARGE_________

Territory: CP&L___ Duke___ DNC Power___ County________________

Name:_____________________ _____________ Age(Minimum age 11)

Male________ Female_____

Address__________________________ City__________________ Zip Code________

Phone ( ___ ) ________________

Years in Electric Project_____Previously attended E. C.: No__ Yes___ Years attended: _____

Project completed this year___________ (Project book 1, 2, 3, or 4)

List up to three of your most current recruiting activities for this year :

1.

2.

3.

How many tours or workshops did you conduct?___

Describe one of your workshop/activities in detail on a separate page or on the back of this page.

Attach a newspaper clipping or 4-H News article advertising your workshop.

Where did you obtain your supplies and materials?

Name the adults who assisted you with your recruiting activities.

How many new 4-H members did you recruit during this year?_______