Return by September 1 to: 4-H Center for Youth Development, 1110 S. College Ave., Room 142, Columbia, MO 65211 hennesss@missouri.edu Youth Service to Communities Club name County______________________________________ Name of club leader Year: Mailing address _________________________________ Number of club members (including Clover Kids) _____________ City, state, zip ___________________________________ Number of volunteer leaders _____________ Sept. 1, 20_____ through Aug. 31, 20_____ LG760 Showing Community Spirit Fundraising Ages 14-18 Connecting with Elected Officials Ages 8-13 Total Group Hours of Service Teaching Others Ages 5-7 Adult Leaders Helping the Environment Senior Youth Helping Others and purpose/description Jr. and Intermediate Youth Building Name of service project Clover Kids Improvements How do these service projects benefit your community? Check the category (or categories) that best describe each service project and tell us more on the back page. Number of youth and adults involved by age Revised 3/14/Web 4-H youth development programs have and continue to serve their communities in many ways. Please offer your thoughts on the following questions: 1. What are the group’s reasons for doing these activities? 2. What do you see as the benefits for the community from these activities? 3. Which skills did 4-H members demonstrate through these activities--mark all that apply (4-H Citizenship Common Measures)? Making informed decisions Being flexible and adaptable Setting goals and determining steps to reach them Communicating with different methods and media Developing positive relationships Identifying and discussing community issues Valuing and respecting differences Working effectively as a team Leading meetings with parliamentary procedure Interacting with local and/or state government leaders 4. What are one or two specific examples of skills you see youth gained through these activities? Published by University of Missouri Extension and the Missouri 4-H Center for Youth Development. An equal opportunity/ADA institution LG760 Revised 3/14/Web