Interest form for becoming a DPA

Full Name *

First Name Last Name

E-mail *

Phone Number *

Area Code Phone Number

Home Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

What county is your home address? *

Birth Date: *

Are you? *

17 and a senior in High School Over 18 and not older than 23

Current School Attending: *

Major (if applicable):

Year in School *

High School Junior High School Senior College Freshman College Sophomore College Junior College Senior Not Currently Attending School

School Attending Next Year:

How do you qualify? *

4-H or FFA member who had/has a dairy cattle project, participated in dairy cattle evaluation or milk quality and products career development event. I am employed, or I am the daughter of, any person presently employed full-time as owner or employee of a milk processing plant or milk distributor or in a dairy-related industry. I am the daughter or granddaughter of any person employed full-time on an operating dairy farm. I've lived or worked on a dairy farm or facility at some time during my life for any period of time. You do not presently have to reside on a dairy! I've volunteered a minimum of 20 hours per year for at least two consecutive years for the Oregon Dairy Women or a county unit. None of the above.

Please note if you are interested and do not qualify by one the the above criteria, you may petition any of the above eligibility requirements by submitting a letter to the Oregon Dairy Women no later than March 1 of the year the candidate intends to compete. If you select "none" above, we'll be in touch with further details!

Parent(s) First and Last Names: *

Why do you want to become an Oregon Dairy Princess Ambassador? *

How did you hear about our program? *

Have you ever volunteered with the Oregon Dairy Women?

Yes No

Enter the message as it's shown *

Oregon Dairy Princess Ambassador Interest Form