Public Service Credit Form

Alabama Master Beekeeper Program  Documentation of Public Service Credits For An Act of Public Service.

(To be completed with assistance from Master Beekeeper Program candidate and signed by representatives from organization sponsoring/hosting the event)

Date:________________

Candidate Name:___________________________________

 (Please circle applicable areas)

1.  Presenting bee-related lecture or workshop to a group as a featured speaker.

2. Officers position in local beekeeping association

3. Appointment by local County Extension office or other municipal agency as expert contact on bee-related questions or issues.

4. Assisting members of youth organizations with project work

5. Mentoring a new beekeeper through at least one complete season.

6. Public demonstration on beekeeping topic at fair, festival or similar public event

7. Providing a hive of bees to pollinate a public garden.

8. Establishing and maintaining observation hive for school or civic group.

9. Other: _____________________________________________________________.

Organization name:  ____________________________________________________

Name of Event:  ___________________________________________________

General Description of Event:  _____________________________________________

______________________________________________________________________

Estimated number of participants/attendees:  ________________________________

Printed Name/Title of Representative:  _______________________________________

Contact Information (phone and/or email) for Signee:  ___________________________

Signature of Representative: _____________________________________

Signature of Master Beekeeper Representative:___________________________(Office Use Only)