MY 4-H RECORD FOR THE ILLINOIS PROJECT HONOR MEMBER AWARD
Name
Club
Year
Number of years I have been a 4-H member (including this year)
(This form may be filled out by 4-H members who are achievement members this year. Report only work done this
year. Include your 4-H project record with this form.)
I.
Maximum
Score
Project Record (60 points)
I am applying for the Project Honor Award in
A. What I learned from this project (2 points for each thing)……................
12
B. I learned more about this project by attending a meeting or event outside
my local club. Meeting or event attended:
_____
5
C. Magazine articles, books, and bulletins I read about the project in addition
to my 4-H project manual (2 points each and give titles of articles)
1.__________________________________________________________
4
2.__________________________________________________________
D. Project work done…………………………………………………………..
20
I did the required work in this project unit (10 points); and required work in
a second project (15 points); OR two time the required work (15 points); OR
three times the required work (20 points); OR I did two times required work in
this project and the required work in a second project unit (20 points):
Name of second project unit:
E. Assistance to other members in this project…………………………………
5
What I did
F. I exhibited my project on a local club project tour or at the local club
achievement program (underline one)………………………………………...
4
G. Rating I received on my exhibit at the County 4-H Show (A=10 points;
B= 7 points; C= 4 points)……………………………………………………..
10
II. 4-H Activity Record (35 Points)
A. My part in the local club program……………………………………………
1. Demonstration, title:
(3 points)
2. Talk, title:
(3 points)
3. Attended club tour other than tour of members’ projects. Place visited:
(3 points)
4. Special feature on club program:
(3 points)
9
Your
Score
Maximum
Score
B. Circle the numbers to show what you did…………………………………
Individual or Club
County
1. Camping
2
3
2. Careers
3
3
3. Citizenship
3
3
4. Demonstration
3
5. Flag Raising
3
District or State
3
3
6. Health
3
3
7. Judging
3
3
3
8. Music
3
3
3
9. People-to-People
3
3
10. Public Speaking
3
11. Safety
3
3
3
12. Work at Fairgrounds Clean-up
3
13. Other
3
3
3
C. Health……………………………………………………………………..
1. Physical examination date
or health check date
2. Dental examination date
20
6
(3 points)
(1 point)
(2 points)
3. I kept my Illinois 4-H Health Record this year (1 point) Yes______ No _____
III. 4-H Leadership Record (5 points)
A. Responsibilities in my local club………………………………………
1.
5
Committees I served on in my club (2 points each – maximum 4)
2. I also held the office of ___________________________ (3 points)
Or was chairman of a committee ____________________ (1 point)
Approved by:
TOTAL
(Local 4-H Club Leader)
Your
Score