CHRISTIAN COUNTY
1120 N. Webster St, Taylorville, Illinois 62568
Telephone: 217/287-7246 Fax: 217/287-7248
This form must be completed and turned in with your 4-H Records by the last Friday in August 28th, 2015.
4-H Records Cover Sheet
Name: ____________________________________________________________________________
Address:
City:
Phone:
Years in 4-H:
Name of Club:
Birthdate:
Award Areas:
Achievement (this focuses on the entire career of the 4-H member. It includes all project areas, leadership shown,
knowledge and skills gained, community service and outside 4-H activities of the member. Must turn in all your records)
Animal Sciences (includes the following areas: Beef, Dairy, Sheep, Swine, Small Pets, Goats, Rabbits, Horses, Dogs,
Poultry, Veterinary Science)
Community Involvement & Global Awareness (includes Citizenship, Service Learning, Community Service &
Intercultural)
Engineering & Technology (includes Aerospace, Bicycles, Computer Science, Electricity Geospatial (GPS/GIS),
Robotics, Safety, Small Engines, Tractor, Welding and Wood Science).
Environmental & Natural Resources Natural Resources, Camping, Outdoor adventures, Sportsfishing, Shooting
Sports, Forestry, Entomology, Geology and Wildlife.
Food, Nutrition & Health (includes Food and Nutrition, and Health – Physical and Mental)
Home & Family (includes Child Care, Intergenerational, Family Relations, Clothing & Textiles, Consumer Education,
Financial Champions, Consumer Savvy, Be the E!, Fashion Revue, and Interior Design.
Leadership (member must be enrolled in Leadership project)
Personal Development (includes Communications, Journalism, Theatre and Performing Arts, Photography,
Filmmaking/Video, Visual Arts, and Recreation)
Plants & Soils (includes Crops & Soils, Floriculture, Horticulture and Plant & Soil Science.
I am applying in the following area(s):
1.
2.
3.
Signatures
Member Signature
Parent Signature
Leader Signature
University of Illinois at Urbana-Champaign College of Agricultural, Consumer and Environmental Sciences
United States Department of Agriculture  Local Extension Councils Cooperating
University of Illinois Extension provides equal opportunities in programs and employment.
Updated 4/2014
MY 4-H RECORDS
Current Year: _________
Participation in Activities: C=County level, L=Local, M=Multi-county, R=Regional, S=State, N=National, I=International
Club Meeting Attendance: (Place a check mark beside each month you attended a meeting and mark n/a if no meeting
held)
September
December
March
June
October
January
April
July
November
February
May
August
Please be specific
Talks &
Demonstrations
Example:
How to
prepare carrot
sticks, L
Radio, TV
presentations &
newspaper articles
written
Club tours & Trips
Example:
Tour of GSI,
L
Workshops &
Conferences
Attended
Example:
Cake
Decorating, C
Speaking for
IL 4-H, S
Exhibits & Displays
Camps
Updated 4/2014
Window
Displays,
Open House,
Etc,
Science
Camp L,
Monticello 4H Camp, S
Space Camp,
N
4-H Judging
Contests
4-H Service
Projects
4-H Federation
Activities
Awards Received
Example:
Livestock,
Horse, Etc.
(Events you
judged)
Example:
Tray Favors,
(# 0f times)
Nursing
Home, L
Example:
Helped with
New Member
Party, Swim
Party, etc.
Awards You
received other
than county
fair awards
4-H Fair Exhibit
Example:
County Fair
and State Fair
awards
received
Other
Example:
International
Night, Job
Shadowing
Updated 4/2014
Project Knowledge and Skills: Explain the things you have learned through your 4-H projects and experiences this year.
Project Area
Example:
Photography
Updated 4/2014
Learned to load film
Took pictures from different angles
Received an A rating at County Fair
Project Knowledge and Skills (Cont’d).
Leadership Exhibited: Show the ways you have provided leadership during your 4-H experiences. Remember, as a
young member you will probably not have very many experiences in this area.
Updated 4/2014
Committee
Committees
Chaired & Club
Offices Held
Junior Leader
Project Leader
Activities
Other
Updated 4/2014
Example:
Refreshment,
Window
Display
Community/School/Other Accomplishments (These are non-Extension on Non-4-H Activities)
Other Activities,
events you have
organized and/or
taught
Other: Sports, Band,
Choir, Key Club,
Student Council,
Scouts, Honors,
Awards
Updated 4/2014
My 4-H Story: The 4-H Story should relate to your projects, as well as your activities or experiences during the period of
September 1 through August 31. Do not mention your name in the story.
Updated 4/2014