4-H Member Record

4-H Member Record

This record is a summary of all of the things you have done while in 4-H. Read all instructions at the beginning of each selection carefully. One line or column is provided for each year. This record can be used in evaluating your progress and planning future work. It will also be the basis for award selection.

NAME / BIRTH DATE (MONTH/DAY/YEAR)
ADDRESS
RT. OR STREETTOWN / ZIP / COUNTYPHONE
CLUB OR GROUP / YEAR I JOINED 4-H

I.PARTICIPATION IN THE LOCAL 4-H CLUB OR GROUP

Begin with your first year in 4-H and list meetings held, meetings you attended, offices held, and committee participation in your local club or group.

YEAR / NUMBER OF MEETINGS / Club or group offices / Committees worked on (indicate the committee chaired with a capital “CH”)
Held after joining / Attended after joining
TOTAL / (PUT TOTALS IN PENCIL)

II.4-H PROJECTS – ENROLLMENT AND EXHIBITS

Begin with your first year in 4-H and list your project by year. Use one row for each year and one column for each project. List the project name at the top of the appropriate column. Indicate the project unit, total size of your project, what you exhibited, and all other work done including articles, animals, recipes, etc. Total the project column in pencil. List county exhibit ratings in column C and state exhibit ratings in column S. Additional inserts of this page are available from your 4-H Leader.

Year / Project / Exhibit / Project / Exhibit / Project / Exhibit
C / S / C / S / C / S
TOTAL

EXAMPLE

Project Beef / Exhibit / ProjecTFoods / Exhibit / ProjectVisual Arts / Exhibit
C / S / C / S / C / S
Beg. Beef Feed
2 steers
Beef Prod I
2 heifers / A
A / Meals
42 meals
20 meats
30 recipes / A / Nature Craft
3- articles
Woodworking
9 – articles / A
B
Project / Exhibit / Project / Exhibit / Project / Exhibit
C / S / C / S / C / S

Have you totaled each column in pencil?

III.PARTICIPATION IN 4-H PROGRAMS

For each year, record the month you participated in each of the programs. The column “where done” refers to where you participated in the program. “Club” refers to what you did on your own or in a program that several or all of your 4-H group participated in. “County” refers to programs offered on the county level. “Multi-County” refers to programs offered for two or more counties. “Regional” refers to programs offered by an Extension Region.

Extra work in a program can be recorded in a written summary. These summaries can be in narrative or outline form. If you prepare a written summary, place an asterisk (*) in the appropriate column and attach the summary to the back of this record.

Year
Program / Where Done
Achievement
Program / Club
County
Animal
Showmanship
Class / County
Multi-County
State
CAMPING
(ex. Younger, older, conservation, forestry) / Club
County
Multi-County
State
CAREER / Club
County
CITIZENSHIP
(ex. Citizenship short course) / Club
Regional
National
CLOTHING
REVUE / Club
County
State
COMMUNITY
SERVICE / Club
County
DAIRY CONFERENCE / National
4-H CONFERENCE / State
4-H FEDERATION
or older-member group / County
Regional
PROGRAM / WHERE DONE
HEALTH / Club
County
JUDGING / Club
County
Multi-County
State
National
TEEN RETREAT / County
Regional
POSTER CONTEST / County
State
PUBLIC
PRESENTATIONS / Club
County
State
National
RECREATION / Club
SAFETY / Club
County
National
SPORTS / County
Regional
State
TRACTOR
OPERATORS
CONTEST / County
State
National
HORSE BOWL / County
State
Regional
DAIRY BOWL / County
State
Regional
SPACE CAMP / National
REGIONAL ROAD TRIP / Regional

List other programs and workshops not listed above:

IV.4-H LEADERSHIP

EXPERIENCE AS A JUNIOR OR TEEN LEADER

Year / List your specific responsibilities and in () indicate the number of members assisted.

LEADERSHIP IN COUNTY, MULTI-COUNTY, REGIONAL, OR STATE PROGRAMS

Indicate major responsibilities with appropriate letter: County (C), Multi-County (M), Regional (R), State (S).

Year / Offices / Committees Worked OnIndicate committee chaired * / Additional Leadership Responsibilities
(Be Specific)

V.COMMUNITY ACTIVITIES

Summarize what you have done in your school, community, and church activities. In the column “other participation” tell what you did in groups or organizations to which you belong, other than offices held and committees chaired – for example, School Band, Church Choir, Basketball Team, Sunday School Teacher, School Choir, Yearbook Staff, Student Council, Cheerleader.

Year / Membership in Groups and Organizations / Offices Held and Committees Chaired / Other Participation / Honors and Recognitions

VI.APPEARANCES IN SUPPORT OF 4-H

Presentation to other groups or appearances on radio or television related to the 4-H program. Indicate the name of the group and topic presented.

Year / Topic / Group / Radio / TV

VII.HONORS AND RECOGNITIONS RECEIVED IN 4-H

List the medals, certificates, trips, bonds, jackets, trophies, gifts, grand champions, etc., received.

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