4-H Green Tomato Contest – Individual Entry Form *

Must be postmarked or faxed by September 30, 2009

Please print

Name: ___________________________________ Social Security Number: _______________

Address: _____________________________________________________________________

PO Box or Street City Zip Code

Date of Birth: ______________________ Email address: ____________________________

Parent’s or Guardian’s name: _____________________________________________________

4-H Green Tomato Contest Entries
Class No.	Class Description	Official	Use	Only

* Form must be complete when submitted or 4-H’er will forfeit any monetary awards.