EmailMeForm
2019-2020 4-H Eligibility
Verification of Eligibility and/or Request for Absence Form
Name of 4-H Member
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First
Last
Parent Phone #
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Primary 4-H Club
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Cattle Drive 4-H
Coryell 4-H Gun Club
Coryell City 4-H
Five Hills 4-H
Gatesville 4-H
Hard Bargain 4-H
Hay Valley 4-H
Hornet Gold 4-H
Jonesboro 4-H
Oglesby 4-H
Pecan Grove 4-H
Spurs -N- Bridles 4-H
In accordance with 4-H policy and TEA Academic Eligiblity Guidelines, I respectfully request:
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Academic Eligibility ONLY (my child will not miss any school class time)
Academic Eligiblity and authorization to receive an excused absence from school for the activities I have indicated below.
You may only choose one!
My Child is in the
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Choose a Grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
10th grade
11th grade
12th grade
at (Campus Name)
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Please select
Gatesville Elementary
Gatesville Intermediate
Gatesville Junior High
Gatesville High School
Evant ISD
Jonesboro ISD
Oglesby ISD
Copperas Cove High School
Copperas Cove Junior High
S.C. Lee Junior High School
Clements/Hollie Parsons Elementary
Fairview/Miss Jewell Elementary
Hettie Halstead Elementary
House Creek Elementary
J.L. Williams/Lovett Ledger Elementary
Mae Stevens Elementary
Martin Walker Elementary
Other
Please check one:
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Public School
Private School
Home School
Name of 4-H Activity or Events
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Date(s) Participating:
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**We (member and parent/s) understand that follow-up details on the member's participation will be provided to schools as required.
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As parent or legal guardian of the aboved mentioned 4-H member I agree that typing my name below serves as my valid signature.
Signature of Parent/Guardian:
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First
Last
Date of Request
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MM
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DD
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YYYY
This information is requested in accordance with the requirements of Senate Bill 1 and in cooperation with the Texas Education Agency and local public school board policies. This form serves as the official school notification of the 4-H member's intent to participate in one or more extra-currcular activities representing 4-H.