Nomination Form for Robert Roggow Leadership Award
Purpose:
This award was established by Robert Roggow to recognize youth who have served in a large
number of youth leadership roles. An assessment of the number of leadership roles nominees
have assumed is done using the 4-H member’s Permanent Record. In addition, the awards
committee would like your insight on the level of involvement the youth has had in the roles they
have indicated on their Permanent Record and how this individual has grown through the
leadership responsibilities. This award is typically presented to a graduating member or a
member within one or two years of graduation. This award can be received once during a
member’s career.
Name of nominee:
Please identify two leadership roles you have seen this member fulfill and describe the level
of responsibility and self-initiative they displayed.
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Please describe how you have seen this member take on leadership roles of increased
complexity as they have progressed through their 4-H career.
Signature of Leader