WausharaCounty 4-H Explore Wisconsin

Purpose of the trip:

  • Learn about the cultural, historical, geographical/geological, political and economic aspects of one geographic region of Wisconsin.
  • Have fun while interacting with other 4-H members and leaders.
  • Experience different aspects of organizing and taking an overnight multi-day trip for a small group

Age: Delegate must be in grades 6-8 at the time of enrollment.

Leader Recommendation: Ask your club’s organizational leader to complete the enclosed recommendation form and return to the Extension Office by predetermined deadline. If your parent is your club’s organizational leader, please ask another leader in your club to complete the recommendation form.

Cost:

●Personal spending money for individual meals and souvenirs.

●The Leader’s Association will provide a 66% scholarship toward the group expenses for travel, lodging, group meals and admissions.

Responsibilities of Participants:

●participate in planning meetings

●report on assigned topics to share with the group in written and oral presentations

● follow through on assumed responsibilities by established deadlines

● show initiative when carrying out responsibilities during the trip

● be a team player when planning the trip and during the trip

● assist with any presentations (Fair, Member and Leader Recognition Day, others as requested)

● be a positive representative of WausharaCounty and of 4-H.

Waushara County 4-H Explore Wisconsin Application

Name Male Female _____

Grade ______Years in 4-H ______

4-H Club ______

Telephone ( ) E-mail address ______

What do you hope to learn from participating in the Explore Wisconsin program?

1.

2.

3.

What are some places in Wisconsin you would like to explore?

1.

2.

3.

What behaviors do you think you need to practice in order to be a good representative of 4-H and Waushara County while participating in this program? Please list a minimum of five behaviors.

1.)

2.)

3.)

4.)

5.)

6.)

If selected to be a delegate, how will you strengthen the team planning and participating in this trip? What attributes do you possess that will make you a strong team member and benefit the group as a whole?

4-H Leadership: Please list the leadership positions you have held as a 4-H member. Leadership roles include club officer positions, youth project leader, and committee chair positions. Attach additional pages if necessary.
4-H Leadership Positions / Year(s) / What Did You Learn?

What leadership goals do you have for the next two or three years?

4-H ACTIVITIES: List activities you have participated in during your years as a 4-H member and what awards and accomplishments you have received. Please check whether it was a club activity or county activity.
4-H ACTIVITIES / CLUB / COUNTY / YEAR(S) / WHAT HAVE YOU LEARNED?
Community service
Demonstration
Festival of the Arts
4-H Summer Camp
4-H Food Stand
Speech at club/speaking contest
Other 4-H Event (please list):
Other 4-H Event (please list):
COMMUNITY, CHURCH, SCHOOL ACTIVITIES OTHER THAN 4-H: List activities you have participated in during school activities including clubs, teams, musical groups, etc.; community groups outside of school in which you have participated for the betterment of your community such as church groups, clubs, Boy or Girl Scouts, volunteer groups, or community art endeavors; and any leadership positions held.
COMMUNITY, CHURCH, SCHOOL / YEAR(S) / WHAT HAVE YOU LEARNED?

LEADER'S RECOMMENDATION FOR EXPLORE WISCONSIN DELEGATES

Please return to: Waushara County 4-H Explore Wisconsin Recommendation, P.O. Box 487, Wautoma, WI 54982. The information contained on this recommendation will be kept confidential.

Youth participating in Explore Wisconsin are to exhibit the qualities of being dependable, willing to show initiative, be responsible for their own actions, get along with others in a positive manner, provide leadership as needed and express information effectively both orally and in written form. If you need more space to comment, please write on the back of the form.

Leader's recommendation for ______

Please rate the member in for each categoryin the chart: (1 is poor, 3 is neutral, 5 is wonderful)

1 / 2 / 3 / 4 / 5
Integrity (Member exhibits moral, ethical and legal behaviors)
Teamwork (Member puts team success before personal success)
Trust/Respect (Member sees and believes in the importance of others, and makes others feel valued)
Caring/ Compassion (Member displays compassion, kindness, concern)
Ownership/Accountability (Member takes responsibility for own work, actions, feelings and behaviors)

1. Why would this applicant be a good representative of WausharaCounty?

2. How does this applicant get along with other youth?

3. Does this member regularly exhibit behaviors that are NOT representative of 4-H?

Yes No If yes, please explain:

I recommend this individual for participation in the Waushara County 4-H Explore Wisconsin program.

______Yes ______No

Please provide a brief explanation of your answer:

______

Leader's Signature