Canadian County Record Book Form

Canadian County Record Book Form

Canadian County Record Book Form

Reporting project work for April 1, ____ thru April 1, ____

Attach a photo

of yourself

Name______

Address ______

City ______State ______Zip ______

Grade in School (this past year) ______Age on January 1 of this year ______

Birthdate ______/______/______

Month/ Day / Year

Year in 4-H ______4-H Club ______

4-H Member - I have completed the project work reported in my Record Book.

Signature of 4-H Member______Date______

Parent/Guardian - I have reviewed this Record Book and know that the 4-H member has completed the work reported.

Signature of Parent/Guardian______Date______

4-H Project Being Reported______

Step 1

What Have I Learned In This Project?

Step 2

Summary of Project Work

Describe the project work done. Include such things as expenses (profit and loss), size of your project (number of animals, number and types of garments made or foods cooked, practice hours, meals prepared, etc.), show the variety of items made from your project manual, self determined projects, educational experiences, activities and events participated in, and other related activities to the project being reported. (Additional pages may be added for Summary of Project Work)

Photos

Up to three pages of pictures may be included for each project reported. Only one side of the page may be used. Photos should immediately follow the summary of project work and should NOT be included in any other section.

Step 3

4-H Citizenship/Community Service

List all4-H citizenship/community service experiences, not just citizenship related to the project reported on pages 1 and 2. Include things that contribute to the welfare of individuals, members of your club or group, or your community. Explain what you did and how many people were affected. (Example: Went with local club to the Spring Hill Nursing Home to sing and you did take cookies that I helped bake. We served 25 residents.) – (Additional pages may be added)

Step 4

4-H Leadership Experiences

List all of your leadership experiences in 4-H (not just leadership for project reported on page 1 and 2), including offices and committees. Leadership is the act of showing/teaching/leading one person or a group. (Examples: 1. Was a member of the calling committee. My responsibility was to call club members about participating in the nursing home visit. 2) Served on the committee who planned the games, songs, and treats for our December nursing home visit.) (Additional pages may be added)

Step 5

Non 4-H Experiences in School, Church and Community

List your most meaningful participation in school, church and community organizations other than 4-H. Include leadership and/or honors received. (Items listed in this section should not be repeated any place else in the 4-H record book.) (Additional pages may be added)

Step 6

My 4-H Story

Write a short story about your current year in 4-H. It should include such things as a reasons for participation in 4-H, things that make 4-H interesting to you and how you have helped other 4-H members. The story can focus on projects or activities reported in a medal form. You may include reasons for selecting the project(s), new things learned and plans for the future. The story should be limited to three pages. If the story is typed please double space.

Revised 1/2017