______

Champaign County

Suite B100

1512 S. U.S. Hwy. 68

Urbana, Ohio 43078

Phone(937)484-1526

Fax (937)484-1540

June 8, 2016

Dear 4-H’er,

Congratulations, you have been nominated to run for 4-H Boy or Girl of the Year. It is a high honor to be nominated for this award. This award began in 1949. It recognizes one boy and one girl, age 17 or 18 as of January 1 of the current year, from Champaign County who has been active in 4-H over the years and is a role model for 4-H. Candidates will be scored on their application, interview with out-of-county judges, appearance, reference, and 4-H participation.

Someone thought highly enough of you to nominate you, so now it’s your turn to complete the process to be considered for this award. Please complete the enclosed application and reference sheet and return by July 13, 2016 to:

4-H Committee

OSU Extension Office

1512 US Hwy 68 South, Suite B100

Urbana, OH 43078

When you submit your application, please include 3 or 4 pictures of yourself with your 4-H projects throughout the years. The application should be typed and include your entire 4-H history.

Interviews will be held on Monday, July 25, 2016. You will be notified of your interview time.

All participants will be recognized in front of the grandstand on Sunday following the Queen Contest and the 2016 4-H Boy and Girl of the Year will be announced at that time.

Good Luck,

Melinda Morrison

4-H Extension Educator

Enc:4-H Boy/Girl of the Year Application

Reference Sheet

Applicant #______

Champaign County 4-H Boy and 4-H Girl of the Year Application

Name:______Age ( 1/1/16) ______Grade Entering ______

Address:______Phone :______

City______State______Zip______

Pg 1 of 6

The following questions apply to 4-H projects and activities only. Do not include FFA participation in projects.

Specify the number of years you were involved in 4-H only with the following projects:

_____ Beef _____Sheep _____ Swine ______Poultry ______Rabbit ______Clothing _____Nutrition

_____Goats _____Dairy ______Non-Livestock _____Creative Arts ______General Home Ec.

______Other ______(specify)

Specify the number of years you were involved in the following 4-H activities:

______4-H Cloverbud ______4-H member ______4-H Camp as camper ______4-H Camp as counselor

County Activities State Activities National/International Activities

_____ Junior Leadership Club _____State Jr. Fairboard _____Citizenship Washington Focus

_____School Awareness Team _____Participated in State Fair _____Labo Exchange Program

_____Junior Fairboard _____Food & Fashion Board _____Other National Activity(specify)

_ ____Food & Fashion Board _____ Teen Conference ______

_____Participated in fair _____State Camp-Leadership/Counselor

_ ____Food & Fashion Board _____State 4-H Ambassador

_____Jr. Council (specify)______State Volunteer Conference

______Other State Activities(specify)______

_____Other County 4-H Activities (specify)______

_____ Other Activities (specify)

MAJOR 4-H HONORS: (5 points) Include 4-H awards, recognition, and other sources of pride and self-esteem.

YearHonor For what Accomplishment

2011 1st Place TrophyState Fair Model Rocketry Evaluation

______

______

DO NOT ADD ADDITIONAL PAGESpage 2 of 6Applicant #______

4-H COMMUNITY SERVICE/CITIZENSHIP: (10 points) Activities performed through 4-H to benefit community.

YearName of ActivityWhat I did, accomplished, or learned

4-H LEADERSHIP: OFFICE/COMMITTEE (5 points)

YearOffice/Committee What I did and/or learned

______DO NOT ADD ADDITIONAL PAGES page 3 of 6 Applicant #______

4-H PROJECT WORK – (10 points) List by major projects and/or program areas. Use numbers when appropriate to show size, extent, growth of number of items, savings, etc. over time.

Year Project Name Things made, produced, learned, etc.

2011 Woodworking Made a bookshelf for my room; worked 57 hours, $72; saved $100;learned to use sander.

______

_______DO NOT ADD ADDITIONAL PAGES page 4 of 6 Applicant #______

4-H PARTICIPATION: (10 points) List 4-H Activities, field trips, tours, workshops, camps, judging events, contests, exhibits.

Year Event What I did; where event took place; including demonstrations and talks given.

_______DO NOT ADD ADDITIONAL PAGES page 5 of 6 Applicant #______

4-H LEADERSHIP: EDUCATIONAL/PROMOTIONAL (10 points)Activities performed to benefit and strengthen 4-H.

YearWhat I did, organized, taught or accomplished

DO NOT ADD ADDITIONAL PAGESpage 6 of 6 Applicant #______

Please submit, along with application and reference an essay about how 4-H contributed to your personal development, leadership skills, and/or career plans and what receiving the honor 4-H Boy/Girl would mean to you. Limited to 2 pages single-sided, double spaced, typed in Arial 11 point font.

CANDIDATE: Please have the following form filled out by one person associated with 4-H.

  • Your 4-H Advisor
  • An Extension Staff Person
  • Someone other than a relative that you have worked with through 4-H

REFERENCE SHEET

Please complete this reference sheet and mail it directly to the Extension Office by Friday, July 13th. The 4-H Awards Committee welcomes your honest answers and appraisal of this member. All information will be kept confidential by the Committee and destroyed after the interviews.

“4-H Boy or Girl of the Year” candidate______

Name

  1. How long have you known this member? ______years
  1. Please check the following areas in which you have worked with the candidate?

Yes No Yes No

Member in 4-H Club ______Chaperone a 4-H Trip ______

4-H Ambassador Club ______Quality Assurance ______

Junior Fairboard ______Skill-a-thons ______

4-H Camp Counselor ______Fair ______

Judging ______Food/Fashion Board ______

Jr. Livestock Councils ______Other (specify) ______

(Swine, Goat, Dairy, Sheep, Rabbit/Cavy, Dairy, Poultry) ______

School Awareness Team ______

On a scale of 1 – 5 (with 5 being the highest) how would you rate the candidate? If the question does not apply, write “NA” under question #.

  1. Always willing to participate in 4-H activity in which you are associated with individual?

Lowest 1 2 3 4 5 Highest

  1. Works well with fellow 4-Hers?

Lowest 1 2 3 4 5 Highest

  1. Shows 4-H Leadership Skills?

Lowest 1 2 3 4 5 Highest

  1. Comes to activities prepared and enthusiastic?

Lowest 1 2 3 4 5 Highest

  1. Participates in 4-H activities because they enjoy it and not because they are forced?

Lowest 1 2 3 4 5 Highest

  1. Shows good sportsmanship in competition situations?

Lowest 1 2 3 4 5 Highest

  1. Is candidate willing to help younger 4-H members?

Lowest 1 2 3 4 5 Highest

-over-

8. What are the member’s strong points? (attach additional sheet if necessary)

9. What makes this applicant a role model for 4-H? (attach additional sheet if necessary)

10. Does candidate follow through with commitments and display leadership roles? (attach additional sheet if necessary)

Reference’s Name:______

Association withcandidate:______

Thank you for taking the time in filling out this form. May we contact you by phone if we have questions concerning your reference sheet? Yes or No Phone:______