Annual Request for Official Approval of the Master Gardener Program and Certification of Nondiscrimination	AFFACT-663 10-16-2014
Name of Group
Purpose of Group
This is to certify the above Master Gardeners Association is open to all eligible persons regardless of race, color, sex, gender identity, sexual orientation, national origin, religion, age, disability, marital or veteran status, genetic information, or any other legally protected status, and is an Affirmative Action/Equal Opportunity Employer.
Master Gardener in charge of Master Gardeners Association (print name)
Signature	Date	County
Official Approval for Master Gardener Association
On the basis of the above purpose(s), the
is authorized to use the Master Gardener name and emblem in connection with its program and activities.
County Extension Agent – Staff chair
(Print name)
County Extension Agent – Staff chair
(Signature)
Date	Enter County