DELAWARE 4-H RECORD GENERAL INFORMATION

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Name: _________________________ Age as of January 1, 20 _____ _____ years old

Complete Address: _________________________________________________________

Town/State/Zip Code: _______________________________________________________

Number of years in 4-H (Including this year): ______ School Grade: ______

Name of Club: _______________________________________

Years Enrolled ~ Project Summary (Include all projects for all years)

Example: Foods 3 Years 2008-2010

I have personally prepared this report and believe it to be true and accurate.

Date: ________ Signature of Member _______________________________________

Date: ________ Signature of Parent/Guardian _______________________________

Date: ________ Signature of 4-H Leader _____________________________________

SPECIAL INSTRUCTIONS:

When presenting information on the following pages,

BE BRIEF in the various sections of this book, and

respond in the form of a numbered list,

not in paragraph form.

DELAWARE 4-H RECORD GENERAL INFORMATION

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LOCAL CLUB OR GROUP RESPONSIBILITIES --- THIS YEAR

Number of members in your club: _____ Regular Members: _____ Cloverbud Members: _____

Number of business meetings held by your club starting from September 1: _____

How many meetings did you attend? _____

List 4-H Offices you held and the committees you served on:

Office or Committee Your Responsibilities

List participation in club meetings for this year. For example: Gave a demonstration, led the pledge, taught a

game, gave a committee report, helped clean up after meeting, arranged meeting room, etc.

CITIZENSHIP / COMMUNITY SERVICE EXPERIENCES List citizenship and community service experiences that you have had this year only.

Total Community Service Hours_____

DELAWARE 4-H RECORD GENERAL INFORMATION

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PARTICIPATION IN 4-H PROGRAMS/ ACTIVITIES (check all you participated in)

County Events:

National 4-H Week ____ County Window Display ____

Achievement Banquet ____ Junior Council Meetings ____

County Demonstration Day ____ Great Pumpkin Day ____

Younger Member Weekend ____ Compact Tractor Driving ____

Junior Leader Weekend ____ Exchange Group ____

Public Speaking Contest ____ Favorite Foods Contest ____

4-H Summer Day Camp ____ 4-H Science Camp ____

County Clothing/Textile Showcase ____ County Sewing Contest ____

Trainings:

Favorite Foods Contest Training ____ State Record Book Training ____

County Record Book Training ____ Club Officer Training ____

Demonstration Contest Training ____ Public Speaking Training ____

Day Camp Counselor Training ____ Poultry Judging Training ____

Photography Judging Training ____ Horse Judging Training ____

Horticulture Judging Training ____ Wildlife Judging Training ____

Livestock Judging Training ____ Horticulture Judging Training ____

Woodworking Judging Training ____ Dairy Judging Training ____

Judging Contests:

Dairy Judging Contest ____ Poultry Judging Contest ____

Woodworking Judging Contest ____ Photography Judging Contest ____

Foods Judging Contest ____ Horticulture Judging Contest ____

Wildlife Judging Contest ____ Clothing Judging Contest ____

Horse Judging Contest ____ Livestock Judging Contest ____

Other Events:

State Environmental Camp ____ Equine Arts Contest ____

State 4-H Camp ____ Cow Camp ____

Holiday Ice Skating Party ____ 4-H State Teen Conference ____

State Horse Bowl Contest ____ Livestock Exposition ____

4-H Legislative Day ____ National 4-H Dairy Conference ____

National 4-H Congress ____ National 4-H Conference ____

PQA Training ____

Delaware State Fair

State Judging Contests ____ State Demonstration Contest ____

State Talent Show ____ State Public Speaking Contest ____

4-H Consumer Bowl ____ 4-H Lawn Tractor Driving ____

4-H Tractor Driving ____ 4-H Archery Competition ____

4-H Avian Bowl ____

DELAWARE 4-H RECORD GENERAL INFORMATION

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Kent County Events:

County Litter Barrel ____ Cloverbud Fun Day ____

County Livestock/Jackpot Show ____ Pygmy Goat Show ____

County Trim a Tree ____ Teddy Bear Drive ____

Holiday Fun Day ____ International Foods ____

Share The Fun Talent Show ____ Livestock Overnighter ____

Winter Fun Day ____ Livestock 101 Social ____

St Patrick’s Day Parade ____ Old Dover Days Parade ____

Photography Contest ____ Basket Auction ____

Kent County 4-H Horse Show ____ 4-H & FFA Spring Dairy Show ____

County Science Club ____ County Tech Team ____

County Robotics Club ____

Sussex County Events:

Pedal Pusher Bike Rides ____ Coastal Clean Up ____

County Archery Training/Shoots ____ County Robotics Club ____

Pumpkin Contest ____ Younger Member Fall Retreat ____

International Foods ____ 4 Little Clovers Talent Show ____

Photography Contest ____ Computer/Graphic Arts Contest ____

Winter Fun Day ____ Holiday Cards for Soldiers ____

Hopkins Farm Tour ____ Sussex County 4-H Horse Show ____

New Castle County Events:

NC County Livestock Show ____ Winter Workshops Attended:

Younger Member Fun Day ____ __________________________ _____

Quest for the Clover 5K ____ __________________________ _____

Shooting Sports Day ____ __________________________ _____

AG Day ____ __________________________ _____

Holiday Clothing Drive ____ __________________________ _____

Ronald McDonald House Kit ____

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PARTICIPATION IN LOCAL CLUB EVENTS List activities and events that you participated in at the club level. Do not duplicate events that have

already been reported in other sections on this form.

CLUB, COUNTY and/or STATE 4-H LEADERSHIP EXPERIENCES---

THIS YEAR

1. Are you a member of the County Junior Council? ______ Number of meetings attended: ____

2. List your leadership participation in the county or state program. (Example: Member of planning

committee, MC, Sold Ads for County Horse Show, host/hostess in 4-H Building, etc.)

3. Are you a Junior Leader? _____ What are your responsibilities in your club or on the county

level?

DELAWARE 4-H RECORD GENERAL INFORMATION

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4. How have you assisted other members in your club or on the county or state level?

5. List other leadership experiences you have had this year in 4-H.

EXPERIENCES AND AWARDS OUTSIDE OF 4-H List and explain important things, other than 4-H, that you have done in school, church, or other groups in your

community, county, or state.

DELAWARE 4-H RECORD GENERAL INFORMATION

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DOCUMENTING YOUR PROJECT

Use this page to record more detail about your general 4-H year. Use pictures, samples, etc. Do not

shingle or overlap items. You may add one additional page for a total of 2 pages for this section. You

are permitted to have photos on the front and back of each page.

DELAWARE 4-H RECORD GENERAL INFORMATION

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MY 4-H STORY

Include a narrative of the past year’s 4-H work that describes your successes, failures, and

experiments. This writing should not exceed 500 words.

last updated 4-22-14