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VIEWS: 3 PAGES: 12

									                               WILL COUNTY 4-H MEMBER RECORD
This record is a summary of all the things you have done while in 4-H. Read all instructions at the beginning of each selection
carefully. One line or column is provided for each year. This record can be used in evaluating your progress and planning
future work. It will also be the basis for award selection.

NAME                                                                                    Birth Date
                                                                                                                     Month/Day/Year


ADDRESS                                                                   COUNTY
                                                                          PHONE

CLUB OR GROUP                                                                                          YEAR I JOINED 4-H


                I. PARTICIPATION IN THE LOCAL CLUB OR GROUP
Begin with your first year in 4-H and list meetings held, meetings you attended, offices held, and committee participation in your local club or
group. The only offices recognized for credit are the following: President, Vice-President, Secretary, Treasurer, Reported and Recreation
Chairman.
                   Number of Meetings
                                                  Club or Group                                Committees worked on
    Year         Held after      Attender          offices held                  (indicate a committee chaired with a capital "CH")
                  joining      after joining
           II. 4-H Projects ---ENROLLMENT, EXHIBITS, EXPERIENCE
Begin with your first year in 4-H and list your projects by year. Use one ROW for each year and one COLUMN for each project. List the
project name at the top of the appropriate column. Indicate the project unit, total size of your project, what you exhibited, and all other work
done (including articles, animals, recipes, etc.). Total the project coumn in PENCIL. List county 4-H exhibit ratings in column "C" and sate 4-
H exihibit ratings in column "S". List leadership activities related to each project in the leadership column. In front of each leadership role
you performed, place in "( )" the "L" if a local event, "C" for county, "M" for multi-county, "R" for regional, "S" for state, "N" for national. (See
example on top of next page.)
Use one page for each project. Additional inserts of this page are available from your 4-H Leader.
                                Project                       Exhibit
                                                                                         Leadership Activities in This Project
    Year                                                      C    S




Total
               Have you totaled project column in PENCIL?
                       Project               Exhibit
                                                                       Leadership Activities in This Project
  Year                 Horse                 C    S
                                                        (c )Horse Project committee member    (c ) Chm Horse Camp
Example                Novice               8-A
                                                        (L) Organized horse grooming workshop (L) Contacted Vet to speak at mtg
                                                        (c )Participated in 4-H petting zoo   (M) Benefit Horse Show Comm Mem
 1990-91               1 Horse              1-B


                       Project               Exhibit
                                                                       Leadership Activities in This Project
  Year                                       C    S




Total
           Have you totaled project column in PENCIL?
                       Project               Exhibit
                                                                       Leadership Activities in This Project
  Year                 Horse                 C    S
                                                        (c )Horse Project committee member    (c ) Chm Horse Camp
Example                Novice               8-A
                                                        (L) Organized horse grooming workshop (L) Contacted Vet to speak at mtg
                                                        (c )Participated in 4-H petting zoo   (M) Benefit Horse Show Comm Mem
 1990-91               1 Horse              1-B


                       Project               Exhibit
                                                                       Leadership Activities in This Project
  Year                                       C    S




Total
           Have you totaled project column in PENCIL?
                              III. PARTICIPATION IN 4-H PROGRAMS
For each year, record the month you participated in each of the programs. The column "where done" refers to where you participated in
the program. "Club" refers to what you did on your own or in a program in which several or all of your 4-H group participated. "County"
refers to programs offered on the county level. "Multi-County" refers to programs offered for two or more counties. "Regional" refers to
programs offered by an Extension Region.
                                                                                       Year
Program                     Where Done
                                           91-92
        Example             Club            May
                            County          July
Achievement                 Club
Program                     County
                            County
Animal Premier
                            State
                            Club
Animal
                            Multi-County
Showmanship
                            County
Class
                            State
                            Club
Camping                     County
                            Multi-County
                            Club
Career Exploration
                            County
                            Club
                            County
Citizenship                 Regional
Ex: Citizenship Focus
                            State
                            National
                            Club
                            County
Clothing Revue
                            State
                            National
                            Club
Community Service
                            County
Dairy Conference            National
                            Club
Demonstration:              County
Proj & Act, Horticulture,
Foods                       State
                            National
4-H Conference              State
4-H Federation              County
                            Club
4-H Week
                            County
Flower Arranging            County
Contest                     State
Haunted House               County
                            Club
Health
                            County
                            County
                            Regional
Horse Bowl
                            State
                            National
Judging


Jr. Leader
Conference
Intercultural
Activities

Nat'l 4-H Congress
Petting Zoo

Public Speaking


Recreation


Safety


Share-the-Fun

Share-the-Fun MC
Tractor Operator
Contest
WORKSHOPS
Agricultural

Dog

General

Home Economics

Horse

Visual Arts
Youth Leader
Training

List other programs and workshops not listed above:
                              IV. 4-H LEADERSHIP - NOT PROJECT RELATED
                                 EXPERIENCE AS A JUNIOR OR TEEN LEADER
            List your specific responsibilities and in "( )" indicate the number of members assisted. EXAMPLE: Directed Share-the-Fun Act (26 ).   Do not
 YEAR       include responsibilities already listed under "Leadership" in Part II.




       V. LEADERSHIP IN COUNTY, MULTI-COUNTY, REGIONAL, STATE, OR NATIONAL PROGRAMS

        Indicate major responsibilities with appropriate letter: County (C ), Multi-County (M), Regional (R ), State (S), National (N)
                                                  Committees worked on                      Additional leadership responsibilities                    (be
Year               Offices Held                     (indicate comm. chaired (CH)                                       specific)
                                                 VI. COMMUNITY ACTIVITIES
Summarize the activities you have participted in your school, community and church. In the column "Other Participation", add "(COM)" after listing of any committee
work. Also include participation such as "Library Aide - Summer Reading Program", "July 4th Parade Participant", "Altar Boy", etc.


                  Membership in groups and            Offices held and committes                                                                       Honors and
   YEAR               organizations                             chaired                                 Other Participation                            Recognition

                School: Mixed Chorus, Basketball                                                                                                    Section Leader
EXAMPLE:                                                       Secretary                Participated in Sectional Chorus Contest; Paper             Captain; Eagle
                Team; Community: Boy Scouts ;
1990-91         Church CTO                                                              Drive (COM); Altar Boy                                      Scout Pin
                            VII. APPEARANCES IN SUPPORT OF 4-H
Presentation to other than 4-H groups or appearances related to the 4-H program. Indicate the name of the group and the topic presented or
the reason for the appearance (ie…Dairy Promotion Float - 4th July Parade).
    Year                       GROUP                                         TOPIC OR REASON FOR APPEARANCE




               VIII. HONORS AND RECOGNITION RECEIVED IN 4-H
List, by years, the medals, certificated, trips, bonds, jackets, trophies, gifts, grand champions, etc., received. Indicate in "( )" club (L), county
(C ), state (S) or National (N).
           YEAR                       YEAR(s) RECEIVED                              AWARD                         YEAR(s) RECEIVED




                                                            APPROVALS
WE HAVE REVIEWED THIS RECORD:
 YEAR           MEMBER                                           PARENT OR GUARDIAN                                       LEADER

								
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