CHRISTIAN COUNTY 1120 N. Webster St, Taylorville, Illinois 62568 Telephone: 217/287-7246 Fax: 217/287-7248 This form must be completed and turned in with your 4-H Records by the last Friday in August______. 4-H Records Cover Sheet Name: ____________________________________________________________________________ Address: City: Phone: Years in 4-H: Name of Club: Birthdate: Award Areas: Achievement Career Focus (this spans your whole career in 4-H and you must turn in all your records) Animal Sciences (includes the following areas: Beef, Dairy, Sheep, Swine, Small Pets, Goats, Rabbits, Horses, Dogs, Poultry, Veterinary Science) Community Involvement & Global Awareness (includes Citizenship and Intercultural) Environmental & Natural Resources (includes Conservation, Camping & Outdoor Living, Entomology, Forestry, Geology, and Wildlife Conservation) Food, Nutrition & Health (includes Food and Nutrition, and Health – Physical and Mental) Home & Family (includes Child Care, Intergenerational, Family Relations, Clothing, Consumer Education, Fashion Revue, and Interior Design and Home Furnishings) Leadership (member must be enrolled in Leadership project) Mechanical Sciences & Technology (includes Aerospace, Bicycling, Computer Science, Electric Energy, Safety, Science, Small Engines, Tractor, and Wood Science) Personal Development (includes Communications, Theatre and Performing Arts, Photography, Visual Arts, and Recreation) Plants & Soils (includes Crops & Soils, Flower Arranging, Flower & Herb Gardening, Vegetable Gardening, Horticulture, and Plant & Soil Science) I am applying in the following area(s): 1. 2. 3. Signatures Member Signature Parent Signature Leader Signature University of Illinois at Urbana-Champaign College of Agricultural, Consumer and Environmental Sciences United States Department of Agriculture Local Extension Councils Cooperating University of Illinois Extension provides equal opportunities in programs and employment. MY 4-H RECORDS Current Year: _________ Participation in Activities: C=County level, L=Local, M=Multi-county, R=Regional, S=State, N=National, I=International Club Meeting Attendance: (Place a check mark beside each month you attended a meeting and mark n/a if no meeting held) September December March June October January April July November February May August Please be specific Example: Talks & How to Demonstrations prepare carrot sticks, L Radio, TV presentations & newspaper articles written Example: Tour of Club tours & Trips Asgrow Seed, L Example: Rookie Workshops & Cooks, C Conferences Legislative Attended Conference, S Window Displays, Exhibits & Displays Display Case, Achievement Night, Ect, Monticello 4- Camps H Camp, S Space Camp, N Example: 4-H Judging Livestock, Contests Horse, Ect. (Events you judged) Example: 4-H Service Tray Favors, Projects (# 0f times) Nursing Home, L 4-H Federation Example: Activities 4-H Olympics Awards You Awards Received received other than county fair awards 4-H Fair Exhibit Example: County Fair and State Fair awards received Other Example: International Night, Job Shadowing Project Knowledge and Skills: Explain the things you have learned through your 4-H projects and experiences this year. Project Area Learned to load film Example: Took pictures from different angles Photography Received an A rating at County Fair Project Knowledge and Skills (Cont’d). Leadership Exhibited: Show the ways you have provided leadership during your 4-H experiences. Remember, as a young member you will probably not have very many experiences in this area. Example: Refreshment, Committee Window Display Committees Chaired & Club Offices Held Junior Leader Project Leader Activities Other Community/School/Other Accomplishments (These are non-Extension on Non-4-H Activities) Other Activities, events you have organized and/or taught Other: Sports, Band, Choir, Key Club, Student Council, Scouts, Honors, Awards My 4-H Story: The 4-H Story should relate to your projects, as well as your activities or experiences during the period of September 1 through August 31. Do not mention your name in the story.
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