Office Use Only

Check #_________
Cash
Amount $__________

REGISTRATION/ORDER FORM
UTAH JUNIOR TURKEY PROGRAM 2012
(ONE participant per form--please fill in all information)

Name ________________________________________________________________
Address_______________________________________________________________
Street or PO Box

City

Zip Code

County________________________ Parents Name/s__________________________

Telephone_(

)______________ Grade in School______ Birthdate ________________

(mm/dd/yyyy)

E-mail_______________________________

4-H Club________________________ FFA Chapter______________________________

Registration form must be filled out completely, appropriately signed, and returned to your
county agent/FFA advisor on or before May 15, 2012. Poults will be available for pick up
on July 18, 2012.
Cost for each poult will be $2.00. (Payment must accompany registration/order form.
Checks should be made out to UJTS)
Youth are required to turn in a 4-H portfolio or 4-H poultry record book or FFA
entrepreneurship pages with their turkey show form in November in order to
participate in the Utah Junior Turkey Show. UJTS scholarships will require a 4-H
portfolio or an FFA record book to be eligible for the competition.

Note: Participants may order up to 15 poults.

Please reserve ________ tom poults and ________ hen poults for me. Poults will be distributed to
counties on Friday, July 18, 2012. I hereby certify that I will personally care for these birds.
Dated this____ day of________, 2012.

Signed____________________________________
Participant
____________________________________
Parent

Approval Signatures
______________________________________
County Agent/FFA Advisor