4-H Participation Summary

(4H-92)

Adair County

4-H Participation Summary

Name County

Address Town Zip

Date of Birth Parents/Guardian

This is a record of your participation in 4-H programs. Summarize your most important accomplishments and experiences each year. This record will help you and other people evaluate your progress. It is understood that beginning 4-H’ers may have fewer entries than those with more experience. That’s okay. This form will help you summarize your participation in 4-H projects, local group involvement, and at community, county, area, and state levels.

Fill in date, age, grade, and years in 4-H as of September 15 of current year.

Year

Name of 4-H Group

Year

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Communications

4-H is sharing ideas and skills you’ve learned with others. List the type of presentation such as a talk, demonstration, working exhibit, Share-the-Fun, newspaper article you wrote, radio, interviews, etc. Use the following code for level of participation: Local (L), County (C), Area (A), State (S). Under local (L) include your 4-H group. Indicate size as L-12, C-35, S-28.

Add extra pages as needed. Use same format as this page.

-3-

4-H Participation

Record here your participation in local, county, state, and national 4-H activities. Use as many lines for each 4-H year as you need.

Events/Activities – Include events/activities such as group projects, parties, workshops, tours, fairs, and day camps.

Add extra pages as needed. Use same format as this page.

-4-

4-H Participation

A 4-H experience begins by participating with other 4-H’ers in a club/group. Record here your participation and responsibilities. Use as many lines for each 4-H year as you need. Indicate number of people in audience if applicable.

Citizenship – Include what you do to help others, 4-H community service projects, etc.

Leadership – Include offices held, committee responsibilities, other leadership responsibilities, etc.

Recognition – Certificates, ribbons, pins, etc. for local level achievements.

Year

Add extra pages as needed. Use same format as this page.

-5A-

4-H Project Summary

Fill in at the end of the year for each project completed. Fill in name of project on the top of each column. Use as many spaces for each project as you need each year. Indicate size, scope of project, or major accomplishments. Use numbers when appropriate to show size, growth, profits, losses, and savings.

Example:

Add extra pages as needed. Use same format as this page.

-5B-

4-H Project Summary

Add extra pages as needed. Use same format as this page.

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Your Home, School, Community Activities

What you learn in 4-H can be applied to things you do in your home, school, and community. Participation in other areas also can support your 4-H program. Summarize your major involvements such as athletics, other organizations, and home responsibilities (such as fix evening meal during summers, mow lawn, etc.). Report participation, leadership roles, and recognition. You may not have entries in all sections each year.

Add extra pages as needed. Use same format as this page.