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______.
4-H Records Cover Sheet
Name: ____________________________________________________________________________
Address:
City:
Phone:
Years in 4-H:
Name of Club:
Birthdate:
Award Areas:
Achievement Career Focus (this spans your whole career in 4-H and you 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 and Intercultural)
Environmental & Natural Resources (includes Conservation, Camping & Outdoor Living, Entomology, Forestry,
Geology, and Wildlife Conservation)
Food, Nutrition & Health (includes Food and Nutrition, and Health – Physical and Mental)
Home & Family (includes Child Care, Intergenerational, Family Relations, Clothing, Consumer Education, Fashion
Revue, and Interior Design and Home Furnishings)
Leadership (member must be enrolled in Leadership project)
Mechanical Sciences & Technology (includes Aerospace, Bicycling, Computer Science, Electric Energy, Safety,
Science, Small Engines, Tractor, and Wood Science)
Personal Development (includes Communications, Theatre and Performing Arts, Photography, Visual Arts, and
Recreation)
Plants & Soils (includes Crops & Soils, Flower Arranging, Flower & Herb Gardening, Vegetable Gardening,
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.
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
Workshops &
Conferences
Attended
Exhibits & Displays
Camps
Example:
Tour of
Asgrow Seed,
L
Example:
Rookie
Cooks, C
Legislative
Conference, S
Window
Displays,
Display Case,
Achievement
Night, Ect,
Monticello 4H Camp, S
Space Camp,
N
4-H Judging
Contests
4-H Service
Projects
4-H Federation
Activities
Awards Received
Example:
Livestock,
Horse, Ect.
(Events you
judged)
Example:
Tray Favors,
(# 0f times)
Nursing
Home, L
Example:
4-H Olympics
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
Project Knowledge and Skills: Explain the things you have learned through your 4-H projects and experiences this year.
Project Area
Example:
Photography
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.
Committee
Committees
Chaired & Club
Offices Held
Junior Leader
Project Leader
Activities
Other
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
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.