Horticultural Connections Activity Registration – Form D

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Fill out the electronic form below and click Submit, or download a PDF of the form that can be printed on WHITE paper and mailed to:

Michael Rethwisch
451 N 5th St
David City, NE 68632-1666

Submit one form for each division as necessary. Must be submitted by September 15.

Note: there is a limit of 16 total teams for this event, with each team consisting of 4 members. Teams will represent states when possible. #2 teams will be utilized if 16 individual state entries are not received by the entry of September 15. Substitutions are allowed, but please contact prior to the convention.

Last Name:
First Name:
Address (Street, City, State & Zip):
Email:
Home Phone:
Cell Phone:

 

Last Name:
First Name:
Address (Street, City, State & Zip):
Email:
Home Phone:
Cell Phone:

 

Last Name:
First Name:
Address (Street, City, State & Zip):
Email:
Home Phone:
Cell Phone:

 

Last Name:
First Name:
Address (Street, City, State & Zip):
Email:
Home Phone:
Cell Phone:

 

Team Name:
Team State:

 

Advisor:
Advisor Address (Street, City, State & Zip):

 

Enter the code below:
captcha

For more information, contact Mike Rethwisch
UNL- Extension
Butler Co.
451 N. 5th Street
David City, NE 68632-1666
(402) 367-7410
mrethwisch2@unl.edu

If you need more information about the categories, please visit the Horticulture Connections page or contact the project chairperson.

Download The Form