Program Fee Reimbursement Request

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This form should be filled out after you have attended an applicable event (listed below). Please fill out a separate form for each youth and event. If you participate in an event not on the list that you think you should receive reimbursement for, please contact the Extension Office to see if it's something we cover. We will let you know if we need anything else from you.

Olmsted County Extension Office
mnext-olmsted@umn.edu, 507-328-6214

Email *

Name of youth:

Event attended (covered by countywide fundraisers)

BLU

TEEL

YELLO

Regional 4-H Camp

CWF (Citizenship Washington Focus)

Ignite by 4-H

4-H horse-related event attended (the horse project will reimburse up to $50 per 4-H'er per year)

Winter Round-up

MQHA Boot Camp

Other - Extension Office will follow up for approval

Who should the check be made out to?

Where should the check be mailed:

my family profile address in 4HOnline

Other:

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