UNION COUNTY 4-H REPORT FORM(Revised 2017)

Year______

Name______

Birthday (month, day, year ______

4-H Club______

Number of Members______

Number of meetings held______Number I attended______

Number of Years in 4-H______

Number of Council Meetings I attended______(three possible)

Did you attend the Leaders Awards Banquet last December?______

Did you receive any county medals or other awards? ______If so, what did you receive?
______

______

Office Held

Club______Council______

State Leadership Team:

State Officer______Leadership Team:______

Committees on which you served (this means in your club or in the county)

Club:______

______

County Committees:______

______

Demonstration (name, when given, to whom).

Project or leadership workshops: example: officer training, leathercraft, baking etc.

Fund Raising:This includes working in the concessions, selling tickets, working at a club or county fund raiser

Club:

County:

CONTESTS:

Tell what contests you competed in, practices you attended and how you placed in the contests. This is the only place where you list your participation in contests.

Contest / Number of practices / County / District / State / National

4-H LEADERSHIP EXPERIENCES

List all leadership experiences. Identify the things that you have done where you planned, organized, or gave directions, either by your self of with others.

Club and council offices

  • Committees you served on
  • Helping younger members with projects
  • Leadership events such as Youth Getaway
  • Senior Leadership retreat
  • District and State and National Contests
  • Achievement Banquet – did you have a role in the banquet
  • Achievement Banquet – what county medals or awards did you win in the previous year
  • Judging Events
  • Fairs
  • National 4-H Conference
  • Citizenship Washington Focus
  • National 4-H Youth Congress
  • National 4-H Week

DO NOT INCLUDE COMMUNITY SERVICE HERE. PUT IT UNDER COMMUNITY SERVICE AND CITIZENSHIP

Level / Leadership Role /

Responsibility

CITIZENSHIP/ COMMUNITY SERVICE

List your citizenship/community service experiences. Include things that help with the welfare of your club or group members, other individuals or community groups andindicate how many people benefited from that you did.

  • Cleanup at the fairgrounds for fair, rodeo, horse show, trash pickup,
  • Trick or Treat So Others Can Eat,
  • Adopt a Grandparent,
  • Christmas donations,
  • Helping to set up or tear down events, such as the Health Fair, Fair
  • Working at the concession stand for the rodeo, fair or other events

Your involvement code:

Y=performed yourself G=gave primary leadership to a group Member of the group.

Kind of Activity / Knowledge and Skills /

Your

involvement

EXHIBITS

List what you entered and how you placed at :

  • Fairs
  • Jackpots
  • Stock Shows
  • Rodeos
  • Horse Shows, Playdays etc.

Example: Union County Fair: Duroc Gilt, placed 3rd, SwineShowmanship, Baking I - muffins, county fair 3rd

Event / What you did / Placing

NON 4-H EXPERIENCES IN SCHOOL, CHURCH, COMMUNITY

List your most meaningful participation in school, church and community organizations other than 4-H. Include leadership roles and honor received.

Activity / Leadership Roles/Honors Received

Year End Story: Write up to four pages front and back, write a story of your experiences in 4-H this year. Tell about your projects, what you liked and what you didn't. Good and bad experiences.

Leadership, citizenship, community service stories and anything else that made your 4-H year special.

SIGNATURE:

______

MEMBERPARENT

______

LEADER

1