Applications & Forms

Applications are due December 1.  Completed applications should be mailed to:

Wisconsin 4-H International Programs
436 Lowell Hall
610 Langdon St.
Madison, WI 53703

OR scanned and emailed to wi4hinternational@gmail.com

Be sure to carefully follow all instructions included with the applications.  Also included with the downloadable applications below are program details, cost information, and expectations.  If you have questions, please contact the Wisconsin 4-H International Programs office at 608-262-2491.

Medical forms for both delegates and adult advisors ARE REQUIRED for International Programs. Please make an appointment with your doctor to fill out the form ASAP, as these forms are due NO LATER THAN February 25th to the WI 4-H International Programs Office. Please note that applicants applying for travel to Japan fill out a different medical form than those applying for other countries (see below).

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Delegates (Youth)

To apply to become an Wisconsin 4-H delegate to Costa Rica, Japan, South Korea, or Finland in Summer 2017, download and complete all portions of this application:

2017 Outbound Delegate Application                                Delegate Medical form (Japan)

2017 Delegate Reference Form                                           Delegate Medical form (Non-Japan)

The completed application includes:

  • Completed and signed application form
  • Photo (email to wi4hinternational@gmail.com preferred)
  • Comprehensive Release Form (signed)
  • Letter of Reference from your school (teacher, principal, etc.)
  • Letter of Reference from your community (4-H leader, civic leader, employer, etc.)
  • Delegate Interview
  • Confidential Statement from your 4-H Youth Development Agent
  • Partial Program Fee of $250 (payable to University of Wisconsin Extension)
  • Program deposit of $1000 (payable to States 4-H International Exchange Programs)

Items due after Dec. 1st:

  • Medical Form, completed by a physician (due February 25th)
  • Copy of passport (due February 25th)

New for 2017! – Harold Brown LEX Exchange Scholarship 

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Adult Advisors (Chaperones)

To apply to become an Adult Advisor for a 4-H youth delegation to  Costa Rica, Japan, South Korea, or Finland in Summer 2017, download and complete all portions of this application:

2017 Chaperone Application                                         Chaperone Medical form (Japan)

2017 Chaperone Reference Form                                 Chaperone Medical form (Japan)

The completed application includes:

  • Completed and signed application form
  • Photo (email to wi4hinternational@gmail.com preferred)
  • Comprehensive Release Form (signed)
  • Chaperone Interview Report
  • Two Letters of Reference from your community
  • Confidential Statement from your 4-H Youth Development Agent
  • Partial Program Fee of $250 (payable to University of Wisconsin Extension)
  • Program deposit of $1000 (payable to States 4-H International Exchange Programs)

Items due after Dec. 1st:

  • Medical Form, completed by a physician (due February 25th)
  • Copy of passport (due February 25th)