I Dare You Award
Nomination Form
Youth must be between 15-18 years old who have completed their freshman
year in high school and show outstanding qualities in servant leadership.
Nominated youth may not have previously been awarded the I Dare You
Award.
Name of 4-H Member:
Age (as of 9/1/12):
4-H Club:
Years in 4-H:
Using the criteria of four fold development, which includes – leadership, scholarship,
physical fitness, and character – briefly state why this member should be considered for the I
Dare You Award. You may use the back of this form if necessary.
Signature of 4-H Leader:
Date: