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2022 OHIO 4H ACHIEVEMENT RECORDNAMEAGE (1/1/22)DATE OF BIRTH GENDER ADDRESS PHONE CITY STATE OH ZIP COUNTERVAIL ADDRESSPLANNED CAREER CLUB/GROUP NAME YEARS IN 4H GRADE IN SCHOOL STATE OPPORTUNITIES:
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Write your name in the designated space provided.
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Fill out your age in the appropriate section.
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Enter your date of birth in the specified field.
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Specify your gender (male, female, other) on the form.

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