Fond Du Lac County 4-H Community Service Member Award Application

Fond du Lac County 4-H Community Service Member Award Application

Service to the community is a fundamental principle of 4-H. Involvement in service helps shape lifelong values. It builds responsibility in members. Youth learn about their community and they take part in meaningful work. Youth increase their confidence, learn to make decisions, learn to work as a team, and realize that they can make a difference in their community. Communities benefit through the work done by youth in a variety of ways such as those in need are cared for, communities are made safer or are beautified, wildlife habitat or the environment is improved, recreational areas are enhanced, or literacy is improved. Many hours of donated time and funds often mean that business or government does not need to invest as heavily in these areas. Because of the positive impact that service has for both the individual and the community, Fond du LacCounty 4-H will recognize youth who have taken leadership in 4-H community service efforts.

Each year up to two youth in grades 5 - 8 and up to two youth in grades 9 – 13 (grades are based on the grade the child was in at the start of the 4-H year, October 1) will be recognized at the Annual
4-H Achievement Program. Applications are due to the Extension Office the day after Labor Day. Members may be recognized only once in each of the two grade divisions. Complete this form as well as providing a statement of support from a 4-H leader or parent that worked with you on planning or carrying out your service. This statement may be attached to this application or mailed directly to the Extension Office by the person writing the statement.

Name ______Grade ______Club ______

Address ______City ______Zip ______

Phone ______E-mail ______

Answer each of the following in the space provided. Please be concise and do not add pages.

1) Describe the community service that you have done as a 4-H member. Include only that done as a 4-H member, not service through other organizations. If you have done more then one 4-H service project you may include information on each one.

______

2) What time period does the service cover (i.e. the last two years, this summer)?

______

3) How many hours have you spent on this effort during this time period?

______

4) How did your effort impact others? Who benefited? How?

______

5) What did you learn from this experience?

______

Optional – On a separate sheet of paper include photos with captions of yourself at work on the community service activity.

2011

4H/Awards/Community Service

Fond du Lac County 4-H Community Service Award – Leader Statement

You are being asked to provide a statement of support for ______

Describe the 4-H community service that this individual has undertakenin the space provided.

How has this person grown through his/her efforts?

How did the recipient of this service benefit?

What was your role in working with this individual on this project?

Your Name ______Your Signature ______

This form may be returned to the applicant or mailed directly to the UW-Extension Office, 227 Admin/Extension Bldg, 400 University Dr, Fond du Lac WI 54935. It must be received by the day after Labor Day.

Fond du Lac County 4-H Community Service Club Recognition

Service to the community is a fundamental principle of 4-H. Involvement in service helps shape lifelong values. It builds responsibility in members. Youth learn about their community and they take part in meaningful work. Youth increase their confidence, learn to make decisions, learn to work as a team, and realize that they can make a difference in their community. Communities benefit through the work done by youth in a variety of ways such as those in need are cared for, communities are made safer or are beautified, wildlife habitat or the environment is improved, recreational areas are enhanced, or literacy is improved. Many hours of donated time and funds often mean that business or government does not need to invest as heavily in these areas. Because of the positive impact that service has for both the individual and the community, Fond du Lac County 4-H will recognize 4-H clubs that have done an outstanding job in 4-H community service efforts.

This form should be completed by the 4-H members and returned to the Extension Office, 227 Admin/Extension Bldg, 400 University Dr, Fond du Lac WI 54935. It must be received by the day after Labor Day. An adult who advised your community service project must write a letter of no more than one page that supports your application. The letter should be attached to your application. Clubs selected for their community service work will be recognized with a certificate at the county 4-H achievement program. Recognition will be given in 2 categories – large clubs and small clubs. Club category will be determined by the number of 4-H clubs and the number of members enrolled in them based upon enrollment records at the UWEX office.

Club ______

___ Large ____ Small Club (Blank to be √ by UW Extension Office)

Name(s) of member(s) submitting this application: ______

4-H members should answer and write responses to each of the following and attach it to this page. If you have several community service activities tell about each of them under each question listed below. (Do not list a community service activity and then answer the 11 questions for it, followed by another activity and your response. Instead take each question and answer for all your activities. For example under each question you might tell about roadside cleanup and your work at an assisted living facility, or whatever your projects were, then do Question 2 and so on.) Submissions will be shared with other clubs.

1) Describe the 4-H community service that was undertaken by your club during this past year.

2) Names and number of members involved ______Number of adults involved ______

3) How and why did the club decide to do this project?

4) If anyone else was involved in this effort besides your 4-H club, tell what role they played.

5) How did your effort impact others? Who benefited? How?

6) What did the members learn from this experience?

7) What was the role of adults in this project?

8) What words of advice do you have for others undertaking a similar project?

9) Include photos with captions & news stories and news photos of the members at work on the community service activity

Bonus for your club: Top placing clubs will have funds donated by the Fond du Lac County 4-H Leader Association, in their club’s name, to the agency the club did community service for. To be considered for this monetary donation, there must be a letter from the agency stating the extent to which the club has aided them. Indicate when the support was given and approximately how many hours of work were done. Be sure to include the address of the agency, a contact person, and the tax exempt number.

4h/awards/community service