Holiday Lake Forestry Camp
2011 Nomination Form

June 13-18, 2011
Holiday Lake 4-H Educational Center
Appomattox-Buckingham State Forest

Holiday Lake Forestry Camp is an academic, structured, residential camp that focuses on field experiences in forestry and other natural resources.

Nominees:

  1. are boys and girls ages 13 to 16;
  2. are Virginia residents;
  3. show an interest in natural resources, and
  4. have not attended before.

A nominator must be a non-related adult who knows the student well. Nominators should print and share the information sheet and discuss the camp with students before making nominations. Nomination does not guarantee acceptance. Nominees will be asked to complete a short questionnaire before being considered.

Nomination Form

All information must be complete. Nomination deadline: April 8, 2011.

Student (Nominee) Information

Nominee items: Nominee Information:
First Name:
Middle Initial:
Last Name:
Date of birth:
Grade:
School:
Student
Address:
City:
State:
Zip Code:
Home Phone:
Student Email:

Parent/Guardian Contact Information

Parent/Guardian items: Parent/Guardian Information:
First Name:
Last Name:
Parent Phone Number:
Parent Email:

Abilities

Ability Poor Rating Fair Rating Good Rating Excellent Rating
Attitude:
Scholastic Standing:
Interest in Natural Resources:
Ability to work with others:

Activities

4-H FFA Scouting Envirothon Ecology/Biology Club
Other Outdoor/Nature-Related Activities:

Reasons for Nomination:

Nominated By

Nominator items: Nominator Information:
First Name:
Last Name:
Title:
School or Affiliation:
Phone Number:
Mailing Address:
 
City:
State:
Zip Code:
Email:

Last modified: Wednesday, 22-Dec-2010 16:25:17 EST

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