10~    {Code 10 = Comment Init   WI  Leader  re-enrollment form}
11~    {Portrait}
13~    {Printer.BeginDoc}
14~80~   {80 Columns}
15~109~   {110 Rows}
20~Arial~  {Font Name}
50~0~     {Brush.style = bsClear}
16~0~     {Set Left Margin}
10~  {Horizontal Lines}
40~6~     {Pen.Width}
21~22~   {Code 21  =  Set Font Size}
22~1~     {Code 22  =  Set Font Style  Set Font Style - Bold}
10~  {Code 30 - print a line of text:  X, Y, 1/4 vertical offset, Text String}
30~10~2~2~Wisconsin 4-H Leader Enrollment Form~
21~8~
30~30~5~3~Please Print Information~
70~2~0~8~7~Clover.bmp~   {Graphic X1, Y1, X2, Y2, File Name}
70~69~0~75~7~Clover.bmp~   {Graphic X1, Y1, X2, Y2, File Name}
21~4~
30~7~6~1~18 USC 707~
30~74~6~1~18 USC 707~
40~16~   {Set pen width = 16}
41~3~8~77~8~  {Horizontal}
41~3~8~3~104~   {Vertical}
41~77~8~77~104~ {Vertical}
40~6~
21~11~
22~0~

30~4~9~0~County~
43~9~11~33~11~0~           {Create Underline ~ Col 9 ~ Row 11 ~ Col 33 ~Row 11~Vertical 1/4 line offset}
22~1~
34~10~9~0~                    {Print County Name ~ Col 10 ~ Row 10 ~ Offset = 0}
22~0~

30~34~9~0~4-H Club~
43~40~11~76~11~0~           
22~1~
36~41~9~0~                  Print Primary Club Name  Col 41  Row 9 Offset 0}
22~0~

30~4~11~2~Last Name~
43~12~13~36~13~2~
62~1~17~1~13~13~11~1~    {Data~VPT[1]~Data File: 17~Field 1~Col 13~Row 13~FSize 11~FStyle~1}
         
30~37~11~2~First Name~
43~45~13~70~13~2~           
62~2~17~2~46~13~11~1~    {Data~VPT[2]~Data File: 17~Field 2~Col 46~Row 13~FSize 11~FStyle~1}

30~71~11~2~MI~
43~73~13~76~13~2~
62~3~17~3~74~13~11~1~    {Data~VPT[3]~Data File: 17~Field 3~Col 76~Row 13~FSize 11~FStyle~1}

30~4~14~0~Street / Mailing Address~
43~20~16~76~16~0~
62~4~17~4~21~16~11~1~    {Data~VPT[4]~Data File: 17~Field 4~Col 76~Row 13~FSize 11~FStyle~1}

30~4~16~2~City~
43~7~18~37~18~2~
62~5~17~5~8~18~11~1~    {Data~VPT[5]~Data File: 17~Field 5~Col 76~Row 13~FSize 11~FStyle~1}

30~38~16~2~State~
43~42~18~62~18~2~
62~6~17~6~43~18~11~1~    {Data~VPT[6]~Data File: 17~Field 6~Col 76~Row 13~FSize 11~FStyle~1}

30~63~16~2~Zip~
43~65~18~76~18~2~
62~7~17~7~66~18~11~1~    {Data~VPT[7]~Data File: 17~Field 7~Col 66~Row 18~FSize 11~FStyle~1}

30~4~19~0~Home Phone~
43~14~21~38~21~0~
62~8~17~8~14~21~11~1~    {Data~VPT[8]~Data File: 17~Field 8~Col 76~Row 13~FSize 11~FStyle~1}

30~39~19~0~Primary Cell Phone~
43~53~21~76~21~0~
10~ 62~9~17~9~56~21~11~1~    {Data~VPT[9]~Data File: 17~Field 9~Col 48~Row 21~FSize 11~FStyle~1}

40~8~   {Pen Width}
30~4~21~2~Gender:~
68~1~17~11~2~  {Check Box Group Number 1 ~ Data File 17 (Lids) ~ Field = 11 ~ Number of boxes (2)}
54~1~1~13~22~0~M~ {Group 1, Box 1, Col, Row, Offset, Value}
30~15~21~2~Male~
54~1~2~23~22~0~F~
30~25~21~2~Female~

40~16~   {Set pen width = 16}
43~3~24~77~24~2~  {Horizontal}
40~8~   {Set pen width = 8}

22~1~
30~4~25~2~Ethnicity: (check one):~
22~0~
68~5~17~29~2~  {Check Box Group Number 5 ~ Data File: 17 (Lids) ~ Field = 55 ~ Number of boxes (2)}
54~5~1~22~26~0~1~ {Group 5, Box 1, Col, Row, Offset, Value}
30~24~25~2~Hispanic or Latino~
22~1~
30~38~25~2~- OR -~
22~0~
54~5~2~44~26~0~2~
30~46~25~2~Not Hispanic or Latino~

22~1~
30~4~28~0~Race (check all that apply):~
22~0~
68~6~17~30~1~  {Check Box Group Number 6 ~ Data File: 17 (Lids) ~ Field = 56 ~ Number of boxes (1)}
54~6~1~29~28~2~1~  {Group 5, Box 1, Col, Row, Offset, Value}
30~31~28~0~White~

68~7~17~31~1~
54~7~1~39~28~2~1~
30~41~28~0~Black or African American~

68~8~17~32~1~
54~8~1~9~30~1~1~
30~11~29~3~American Indian or Alaskan Native~

68~9~17~33~1~
54~9~1~39~30~1~1~
30~41~29~3~Asian~

68~10~17~34~1~
54~10~1~9~32~0~1~
30~11~31~2~Native Hawaiian or Other Pacific Islander~

68~11~17~35~1~
54~11~1~39~32~0~1~
30~41~31~2~More than one Race~

68~12~17~36~1~
54~12~1~59~32~0~1~
30~61~31~2~Undetermined~

22~1~
30~4~35~0~Residence:~
22~0~
68~4~17~13~5~  {Check Box Group Number 4 ~ Data File: 17 (Lids) ~ Field = 15 ~ Number of boxes (5)}
54~4~1~14~35~2~1~
30~16~35~0~Farm~

54~4~2~22~35~2~2~
30~24~35~0~Rural Non-Farm or Town less than 10,000~

54~4~3~54~35~2~3~
30~56~35~0~Town/City 10,000 to 50,000~

54~4~4~14~37~2~4~
30~16~37~0~Suburb of City over 50,000~

54~4~5~39~37~2~5~   {Group 3, Box 5, Col, Row, Offset, Value}
30~41~37~0~City over 50,000~

40~16~   {Set pen width = 16}
41~3~40~77~40~  {Horizontal}
40~8~   {Set pen width = 8}

30~4~41~1~Year in 4-H (Incl. this yr.)~
43~23~42~27~42~2~
62~12~17~14~24~42~11~1~    {Data~VPT[13]~Data File: 17~Field 18~Col 72~Row 26~FSize 11~FStyle~1}

22~1~
30~4~43~2~Leader Type:~
22~0~
68~13~17~15~8~  {Check Box Group Number 13 ~ Data File 17 (Lids) ~ Field = 15 ~ Number of boxes (8)}

54~13~1~14~44~0~82~  {Group 13, Box 1, Col, Row, Offset, Value}
30~16~43~2~Organizational/General~

54~13~2~42~44~0~83~  {Group 13, Box 1, Col, Row, Offset, Value}
30~44~43~2~Project~

54~13~3~14~46~0~84~  {Group 13, Box 1, Col, Row, Offset, Value}
30~16~45~2~Activity~
43~21~47~40~47~0~           {Create Underline ~ Col 61 ~ Row 45 ~ Col 75 ~Row 45~0 Vertical 1/4 line offset}

54~13~4~42~46~0~85~  {Group 13, Box 4, Col, Row, Offset, Value}
30~44~45~2~Resource~
43~51~47~75~47~0~           {Create Underline ~ Col 9 ~ Row 11 ~ Col 33 ~Row 11~Vertical 1/4 line offset}

54~13~5~14~48~0~86~  {Group 13, Box 5, Col, Row, Offset, Value}
30~16~47~2~Key~
43~19~49~40~49~0~           {Create Underline ~ Col 9 ~ Row 11 ~ Col 33 ~Row 11~Vertical 1/4 line offset}

54~13~6~42~48~0~87~
30~44~47~2~County Committee~
43~57~49~75~49~0~           {Create Underline ~ Col 9 ~ Row 11 ~ Col 33 ~Row 11~Vertical 1/4 line offset}

54~13~7~14~50~0~88~
30~16~49~2~Club Enrollment~

54~13~8~42~50~0~89~
30~44~49~2~Adult Advisor~

40~8~   {Pen Width}
30~4~52~0~4-H Alumni:~
68~3~17~16~2~  {Check Box Group Number 3 ~ Data File 17 (Lids) ~ Field = 16 ~ Number of boxes (2)}
54~3~1~14~52~2~Y~ {Group 3, Box 1, Col, Row, Offset, Value}
30~18~52~0~Yes~
54~3~2~22~52~2~N~
30~24~52~0~No~

30~4~55~0~Primary E-mail Address~
43~21~57~76~57~0~
62~11~17~19~22~57~11~1~    {Data~VPT[14]~Data File: 17~Field 24~Col 46~Row 28~FSize 11~FStyle~1}

40~8~   {Pen Width}
30~4~58~0~I Will Accept E-mail Communication:~
68~2~17~58~2~  {Check Box Group Number 2 ~ Data File: 17 (Lids) ~ Field = 63 ~ Number of boxes (2)}
54~2~1~31~58~2~1~ {Group 2, Box 1, Col, Row, Offset, Value}
30~33~58~0~Yes~
54~2~2~40~58~2~0~
30~42~58~0~No~

40~16~   {Set pen width = 16}
41~3~61~77~61~  {Horizontal}
40~8~   {Set pen width = 8}

21~10~
51~4~63~5~64~
30~6~62~2~Yes~
51~9~63~10~64~
30~11~62~2~No~
30~14~62~2~I want the University of Wisconsin-Extension to keep my name and contact information~
30~14~64~2~ private when creating a public record or list.~

51~4~68~5~69~
30~6~67~2~Yes~
51~9~68~10~69~
30~11~67~2~No~
30~14~67~2~I grant the University of Wisconsin Board of Regents and University of Wisconsin-Extension~
30~14~69~2~(hereinafter University) the right to publish, and copyright my image (including audio, moving image or~
30~14~71~2~photography) for educational programs, websites, and promotion of University programs.~

51~4~75~5~76~
30~6~74~2~Yes~
51~9~75~10~76~
30~11~74~2~No~
30~14~74~2~I require an accommodation for a disability to participate in this program.~

40~16~   {Set pen width = 16}
41~3~77~77~77~  {Horizontal}
40~6~   {Set pen width = 8}

21~11~
22~1~
30~4~78~2~Additional Communications Information~

22~0~
30~4~82~0~Primary Cell Phone Carrier (for number noted in first section)~
43~47~84~76~84~0~
10~    62~0~44~8~48~85~11~1~  

40~8~   {Pen Width}
30~4~84~2~I Will Accept Text (SMS) Messages:~
10~  68~15~17~1~2~  {Check Box Group Number 15 ~ Data File: 17 (Lids) ~ Field = 13 ~ Number of boxes (2)}
54~15~1~31~85~0~Y~ {Group 15, Box 1, Col, Row, Offset, Value}
30~33~84~2~Yes~
54~15~2~37~85~0~N~
30~39~84~2~No~

30~4~87~0~Work Phone~
43~14~89~32~89~0~
62~10~17~9~16~89~11~1~  

30~34~87~0~Ext~
43~38~89~76~89~0~
10~    62~0~17~0~40~89~11~1~

30~4~90~0~Alternate Cell Phone Number~
43~25~92~76~92~0~
10~    62~0~17~0~27~92~11~1~

30~4~93~0~Alternate E-mail Address~
43~22~95~76~95~0~
10~    62~0~17~0~24~95~11~1~

30~4~96~0~Alternate E-mail Address~
43~22~98~76~98~0~
10~    62~0~17~0~24~98~11~1~

22~1~
33~42~102~0~Form Continues on Next Page~

40~16~   {Set pen width = 16}
41~3~104~77~104~  {Horizontal}
40~6~

70~5~105~16~109~UWEXCE.bmp~   {Graphic X1, Y1, X2, Y2, File Name}
21~8~
30~17~106~0~An EEO/AA employer, the University of Wisconsin-Extension provides equal opportunities in employment and~
30~17~107~2~programming including Title IX and American with Disabilities Requirements.~

61~12~  {Number of FPT data variables}
67~13~  {Set Number of Check box groups}

23~ {Exit for processing}