Youth Proficiency Award Application
Applications are due October 15, 2019
First Name  
Last Name  
Parent/Guardian Name  
Farm Name  
Date of Birth  
Applicant's Address  
City & State  
Zip Code  
Phone Number  
Email Address  
4-H Club/FFA Chapter  
Leader  
Where show feed was bought 
If Country Visions, which location 
Species of animal to be shown (heifer, pig, etc.) 
Feed Consultant  
As the parent/guardian of applicant above, I give CP Feeds and Country Visions the right to use images of said applicant 
Please type the text in the box.


   
     

 
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