2017Fairfield County Outstanding 4-H’er Form
- General Requirements (Must Meet All)Name: ______
_____ At least a Senior in High School as of January 1 of the current year
_____ 4-H Member in good standing for the current year
_____ Completed an Ohio 4-H Achievement Record
- Leadership (Total points for Leadership must be at least 75 points, count each item only once)
Club (5 points each)
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____Club Officer (5)
____Club Committee Chair (5)
____ Host/Organize Club Tour (5)
____ Taught Club Workshop (5)
____ Mentor younger member withproject (5)
____ Club Other (5)
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County (10 points each)
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_____ County Club Officer (10)
_____ County Committee Chair (10)
_____ Host/Organize County Tour (10)
_____ Taught County Workshop (10)
_____Volunteer at County Event (10)
_____ Emcee Event (Panorama,
Advisory Banquet, Officer
Training, Summerfest, etc.) (10)
_____ Junior Leaders (10)
_____ Junior Fair Board Member (10)
_____ Junior Fair Board Jr. Advisor (10)
_____ 4-H Advisory Board Youth rep. (10)
_____ Endowment Board Youth Rep.
(10)
_____ Senior Fair Board Youth Rep. (10)
_____ Show Committee (10)
_____ Sale Committee Youth Rep. (10)
_____ County Camp Counselor (10)
_____ Fashion and Nutrition Board (10)
_____ County Other (10)
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State (15 points each)
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____ State Club Officer (15)
____State Committee Chair (15)
____ Host/Organize State Tour (15)
____ Taught at State Workshop (15)
____ Volunteer at State Event (15)
____ Emcee Event (State Banquet, Style
Review, etc.) (15)
____ State Junior Fair Board (15)
____ State Fashion Board (15)
____ State Camp Counselor (15)
____ State 4-H Ambassador Member
(15)
____ State Teen Advisory Council
Member (15)
____ Healthy Living Youth Advocate (15)
____ State Other (15)
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- 4-H Promotion (Complete any Two (2) of the following items)
____ 4-H Day Assistant
____ Assist with educational display/exhibit at the Fair
(Jr. Fair Board Posters, calf petting zoo, Ag Adventures display, etc.)
____ Fair Queen or Attendant/ Livestock Queen, Ambassador, Representative
____ Host and or maintain Club website (Social Media, Website, Facebook, Instagram, etc.)
____ Have written or published news articles (at least 3)
____ Successful completion of the Ohio 4-H Ambassador Program (2 Year Term)
____ Successful completion of the Ohio 4-H Teen Advisory Council Program (2 Year Term)
____ Radio or TV Appearances promoting 4-H (at least 2)
____ Participate in organized member recruitment efforts (at least 2) (School visits,
4-H week activities, etc.)
____ Other
Name: ______
- Project Work (Have completed work in at least Five (5) areas)
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____ Beef & Steer
____ Child Care
____ Clothing
____ Communications
____ Conservation/Nat. Res.
____ Dairy
____ Dogs
____ Field Crops/Gardening
____ Food & Nutrition
____Genealogy
____ Goats
____ Health
____ Home Decorating/Design
____ Home Equipment
____ Horses
____ Introduction to 4-H
____ Leisure Activities
____ Llama/Alpaca
____ Money Management
____ Personal Development
____ Poultry
____ Rabbits
____ Sheep
____ Small Animals/Pets
____ Tech/Mech Science
____ Veterinary Science
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____ Shooting Sports ____ Swine
____ Leadership ____ Miscellaneous
- Citizen and Community Service (Must have two (2) of the following)
____Participate in at least three (3) different community service projects with your 4-H club
____ Participate in at least two (2) different community service projects as part of your
4-H project
____ Plan, organize, and conduct a major community service project with a 4-H club
____ Participate in at least three (3) different community service projects as part of a 4-H
Program(teen conference overnighter, camp, etc.)
____ Citizenship activities (complete at least one (1)of the following items
4-H International Study Program or Host Family, Washington Focus/Heritage Tour,
Election Day Teen Volunteer, Volunteer for a Political Campaign, Assist with
Voter Registration Drive, Visit and Observe a session of the Ohio House of Representatives,
Ohio Senate, or U.S. Congress, Observe a local government official at their job for a day,
observe at least three county or municipal court trials, tour a local government agency,
attend a County Commission meeting, attend a School Board meeting, attend a township
trustee or city council meeting, Citizenship Washington Inaugural Trip
- Participation(Participation areas must have at least 150 points total;count each item once)
Club Participation (5 points each)
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_____ Cloverbud Member (5)
_____ Club Scrapbook (5)
_____ Club Educational Tour (5)
_____ Club Committee Member (5)
_____ Club Workshop (5)
_____ Club Demonstration (5)
_____ Club Other (5)
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County Participation (10 points each)
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____ County Educational Tour (10)
____ County Committee Member (10)
____ County Workshop (10)
____ County Demonstration Contest (10)
____ County Summer Judging (10)
____ County Fair Exhibitor (10)
____ County Showmanship (10)
____ County Super Showmanship (10)
____ County Skill-a-thon (10)
____ County Livestock Judging Contest (10)
____ County Speaking Contest (10)
____ County Officer Training (10)
____ Horse PAS Show (10)
____ Interview for Fair Queen/Livestock
Queen, Representative,
Ambassador (10)
____ County Fair Asst. (Display Barn
Guard, NOT show committee) (10)
Name: ______
____ County 4-H Camp (10)
____ Citizen Washington Focus (10)
____ Leadership Washington Focus (10)
____ Carving New Ideas (10)
____ Talent Show/Skit (10)
____ Ohio 4-H Conference Overnighter (10)
____ Summerfest (10)
____ County Other (10)
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District/State Participation (15 points each)
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____ State Committee Member (15)
____District Speaking contest (15)
____ State Speaking Contest (15)
____ State Workshop (15)
____ State Demonstration Contest (15)
____ State Summer Judging (15)
____ State Fair Exhibitor (15)
____ State Fair Showmanship (15)
____ State Fair Super Showmanship (15)
____ State Livestock Judging Contest (15)
____ State Skill-a-thon (15)
_____ Ohio 4-H Conference (15)
_____ Ohio Leadership Camp (15)
_____ Sea Camp (15)
_____Ohio Forestry Camp (15)
_____State Junior Fair Board (15)
_____State Fashion Board (15)
_____ Ohio Fair Manager Conference(15)
_____Operation/Ohio Military Kids (15)
_____Ohio Dairy Goat Conference (15)
_____District/State Other (15)
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National Participation (20 points each)
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____ National Livestock Show (20)
____ National 4-H Conference-D.C. (20)
____National 4-H Congress-Atlanta (20)
____ National Dairy Conference (20)
____ Host an Exchange Student (20)
____ 4-H International Travel
Abroad/Exchange Student (20)
____ National Other (20)
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- Non 4-H Activities(Must have involvement in at least Four (4) items)
____ Boy/Girl Scouts ____ Honor Roll ____Part-Time Job
____ Breed Association ____ Music (choir/band) ____ School/Co-Op Club Member
____ Campfire ____National Honor Society ____ Officer/Volunteer(non 4-H
____Church Member ____Sports Team (member/coach) Group/Activity)
____ FFA Member ____ Student Council Member ____ Student Tutor
____ Grange ____ Non 4-H Travel Abroad ____ Other
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