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Click ‘Get Form’ to open it in the editor.
Begin by entering your name in the designated field for 'applicant name'. Ensure that you spell it correctly as this will be used throughout the application process.
Next, fill in your place of birth, including the city and state. This information is crucial for identification purposes.
Provide your date of birth in the format mm/dd/yyyy. This helps verify your age and eligibility.
In the authorization section, read through the consent statement carefully. Once you understand it, sign where indicated to authorize the investigation into your moral character.
If applicable, identify your branch of military service. If not, simply state 'not applicable'.
Finally, ensure that a notary public witnesses your signature. They will need to print their name, sign, and provide their commission expiration date.
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Licking County 4-H | Page 159 - U.OSU - The Ohio State University
Attention Club Health and Safety Officers! Below are some resources from Ohio 4-H that may be helpful for you as you service your officer role for your club
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