Formerly the Member Evaluation Form AKA M.E

4-H ExcursionApplication

Formerly the Member Evaluation Form AKA M.E.

DUE OCTOBER 15, 2016

Name: 4-H Club:

Parent/Guardian: Phone #:

Age (as of January 1): Date of Birth(m/d/y): Years in 4-H:

A complete application includes:

___Application Form (checking the trips interested in)

___Resume (follow template directions)submit only 1 resume

___1 page typed essay (3 paragraphs) for each trip of interest

___Recommendation from General Leader (if general leader is your parent/guardian another leader inyour club can submit the recommendation)

___Interview Date (one interview for all interested trips)

__ Monday, November 9th in Thorp (location TBA) start time 4pm

__ Tuesday, November 17th in Neillsville (Courthouse) start time 4pm

__ Sunday, November 22ndin Greenwood (ADS) start time 2pm

Please select the COUNTY based trips you are interested:

___ Inter-State Exchange Trip/Delaware travels to Wisconsin – NO INTERVIEW REQUIRED

In 2016 Clark County will host 4-H youth from Delaware

___ WisconsIn-State Trip/Late June or July – NO INTERVIEW REQUIRED

Youth in grades 5th – 8th as of October 1, 2015

Travel with Clark County youth to an area in Wisconsin that the youth choose and set up a travel itinerary.

Please select the STATE based trips you are interested:

___ Space Camp/April 21-25, 2016

Huntsville, Alabama at U.S. Space & Rocket Center

Youth in grades 6th – 8th as of October 1, 2015

Explore the fascinating world of space exploration, space science and technology.

___ 4-H American Spirit East Experience/Dates: ______TBA (early June)

Indiana/Ohio/Pennsylvania/New York/Canada

Youth in Grades 9th – 10th as of October 1, 2015

4-H members from Northwestern Wisconsin will travel to the east coast (via bus) and visit multiple attractions including Valley Forge, Plymouth whale watching cruise, Niagara Falls and much more!

___ 4-H American Spirit West Experience/ Dates: June 20-30, 2016

South Dakota, Montana, Wyoming

Youth in Grades 9th – 12th as of October 1, 2015

4-H Members from Northwestern Wisconsin will travel west (via bus) starting in St. Croix then through the Black Hills ending in Yellowstone National Park. The National Parks is celebrating 100 years in 2016. Trip participants will be tent camping along the way. Current estimated cost $1500.

___ Wisconsin 4-H & Youth Conference/ June 20 – 23, 2016

Madison, WI

Youth in 8th grade or higher as of October 1, 2015

4-H members from around Wisconsin learn about the UW-Madison campus and take part in seminars to learn more about themselves, future careers, and government. They are encouraged to take what they learn and share it with others in their home/community.

___ Leadership Washington Focus/ July ____, 2016 TBA

Washington D.C.

Youth in grades 6th -8th as of October 1, 2016

Participants will practice effective communication with others through group discussion and public speaking, work with others to create and accomplish goals, experience hands-on learning.

___ Citizenship Washington Focus CWF (tentative dates):

June 25-July 3, 2016 – week 4; July 9-17, 2016 – week 6; July 16-24, 2016 – week 7

Washington, DC

Youth in grades 10th-12th as of October 1, 2015

Youth participate in seminars on citizenship, leadership, government, and civic responsibility. Tour historic sites and meet with senators and congressmen. Travel time is Friday to the following Saturday.

Please select the NATIONAL based trips you are interested:

____ National 4-H Conference/April 8-14, 2016

Washington, DC

Youth in grades 10th – 12th as of October 1, 2016 (maximum age of 18 as of January 1, 2015)

A state application will be required

Each participant selects an issue (e.g. education, promotion, environment, etc.) and works with other youth from across the country to develop plans to help direct future 4-H programming.

____ National 4-H Congress/Nov 25-29, 2016

Atlanta, Georgia

Youth in grades 10th – 12th as of October 1, 2015 (maximum age of 18 as of January 1, 2016)

Delegates participate in self-development seminars, tours, and a service project, while exchanging ideas with youth from across the country.

Please select the INTERNATIONAL based trips you are interested:

____ Summer Inbound International Exchange (July – August, 2016) 4 week program

Hosting youth ages 10 – 18 years of age

Countries: Argentina, Japan, South Korea, Mexico, Norway,

____ Summer Outbound International Exchange (July – August, 2016) 4 or 8 weekprogram

____ Academic Year Inbound International Program (July or August 2016 throughMay-June 2017)

YourName

YourAddress

YourEmail Address

Your Phone number (home or cell)

EDUCATION

List school/Home school and current grade

4-H INVOLVEMENT (list in bullet form)

Club Involvement

• Officer positions held
• Youth Leader opportunities within your club
• Service Opportunities
• Drama Fest/ Volleyball/Softball

County Involvement

• Junior Leaders
• Camp Counselor
• Shooting Sports

Trips/Events/Awards

• Have been a camper at 4-H camp (note year(s))
• WisconsIN-State trip (note year(s))
• American Spirit, Washington DC, Madison, etc. (note year)

County Fair

• Project areas currently participating in
• Clark County Fair cleanup

SCHOOL & COMMUNITY INVOLVEMENT

School

• Organizations
• Sports
• Drama/Forensics

Community

• Faith based
• Service Groups

ACHIEVEMENT/SKILLS

• Awards or honors received
• Trainings participated in etc.

YourName

Trip Name (one essay for each trip of interest)

In three (3) paragraphs share WHY you are interested and want to attend XYZ trip. Share your value of 4-H, knowledge and skills you have gained or experienced and how that will be enhanced with your participating in a new opportunity. How have or will you share your experience when you return to your 4-H club?

100 Great Resume Words
Assist
Able
Action
Analysis
Achievement
Accomplished
Advanced
Conduct
Consult
Committed
Conducted
Contributed
Coordinated
Delegated
Develop
Deliver
Design
Defined
Diversified
Devoted
Distinguished
Encourage
Earned
Enhance
Evaluate / Examined
Facilitate
Formulate
Fulfilled
Forecasted
Generated
Gained
Gathered
Gave
Headed
Hosted
Identified
Implemented
Improved
Improvised
Influenced
Launched
Lobbied
Maintained
Managed
Marketed
Maximized
Mediated
Modernized
Motivated / Negotiated
Observed
Obtained
Operated
Organized
Originated
Overhauled
Oversaw
Participated
Performed
Pioneered
Planned
Prepared
Presented
Promoted
Provided
Published
Pursued
Quantified
Ranked
Received
Recommended
Redesigned
Reengineered
Reorganized / Represented
Restructured
Revised
Safeguarded
Secured
Selected
Specified
Spearheaded
Standardized
Strengthened
Structured
Suggested
Superseded
Supervised
Targeted
Taught
Tested
Trained
Transcended
Unified
Upgraded
Utilized
Validated
Valued
Wrote

Selected Candidates Financial Assistance from the 4-H Leaders Federation

50% Leaders Federation cover

30% Additional coverage if participant presents experience to another 4-H Club by end of year

20% Covered by candidate