Maryland 4-H Diamond Clover Award Program
Level Four (Sapphire) - Plan & Report
Name ______Phone ______
Address ______
Town/State/Zip ______
4-H Unit (County/City/Military 4-H Program) ______
Club(s) ______
Age ______Birth Date ______Years in 4-H ______(including this year)
Level Four Diamond Clover Plan(complete at the beginning of the 4-H year)
Check at least six tasks/skills you plan to accomplish this 4-H year:
____ Attend at least 60% of club meetings
____ Serve as a club/group officer or committee chair
____ Provide leadership for a club service-learning project
____ Provide leadership for a club fundraiser
____ Compete in the county public speaking contest
____ Attend at least three local 4-H unit (County/City/Military 4-H Program)activities
____ Attend at least one regional or state 4-H event
____ Help a younger member with their project, demonstration or learning the pledge
____ Attend a resident camp
____ Complete at least one 4-H project from a project area not previously worked in
I have reviewed this plan and find it complete, accurate and adequate to meet the requirements of Level Four (Sapphire) of the Maryland 4-H Diamond Clover Award Program.
4-H Member Signature ______Date ______
Parent/Guardian Signature ______Date ______
Club Leader Signature ______Date ______
------Llevel Four Diamond Clover Report(complete at the end of the 4-H year)
List the tasks completed/skills learned and the date completed below.
First Task/Skill______Date ______
Explain what you did/learned: ______
______
______
______
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(Attach additional pages as needed)
Level Four Diamond Clover Plan/Report – Page 2
Second Task/Skill______Date ______
Explain what you did/learned: ______
______
______
______
Third Task/Skill______Date ______
Explain what you did/learned: ______
______
______
______
Fourth Task/Skill ______Date ______
Explain what you did/learned: ______
______
______
______
Fifth Task/Skill ______Date ______
Explain what you did/learned: ______
______
______
______
Sixth Task/Skill ______Date ______
Explain what you did/learned: ______
______
______
Equal opportunity employer and equal access programs Revised 3/08 - dht
Level Four Diamond Clover Plan/Report – Page 3
Additional Task/Skill______Date ______
Explain what you did/learned: ______
______
______
______
Additional Task/Skill______Date ______
Explain what you did/learned: ______
______
______
______
Additional Task/Skill______Date ______
Explain what you did/learned: ______
______
______
______
I have reviewed this report and find it complete, accurate and meeting the requirements of Level Four (Sapphire) of the Maryland 4-H Diamond Clover Award Program.
4-H Member Signature ______Date ______
4-H Parent/Guardian Signature ______Date ______
4-H Club Leader Signature ______Date ______
Use the back of this page if additional space is needed
Equal opportunity employer and equal access programs Revised 3/08 - dht