Diamond Clover Award

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: ______

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Third Task/Skill______Date ______

Explain what you did/learned: ______

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Fourth Task/Skill ______Date ______

Explain what you did/learned: ______

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Fifth Task/Skill ______Date ______

Explain what you did/learned: ______

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Sixth Task/Skill ______Date ______

Explain what you did/learned: ______

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______

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: ______

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Additional Task/Skill______Date ______

Explain what you did/learned: ______

______

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______

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