CLINTON COUNTY INTERMEDIATE/SENIOR
4-H PROJECT AWARD APPLICATION FORM
Name _______________________________________ Years involved in 4-H program __________
Address _________________________________________________________________________
Current Grade in School _________ Age _________ Club ________________________________
Award Areas – For youth who have completed 7 – 12 grades ( the area(s) you are applying for)
Animals
 Beef
 Breeding Beef
 Market Beef
 Bucket Bottle Calf
 Dairy Cattle
 Dairy Goat
 Dog
 Horse & Pony
 Meat Goats
 Pets
 Poultry
 Rabbit
 Sheep
 Swine
 Veterinary Science
Comments:
.
Creative Arts
 Music
 Photography
 Visual Arts
Family & Consumer Sciences
 Child Development
 Clothing & Fashion
 Consumer Management
 Food & Nutrition
 Health
 Home Improvement
 Sewing & Needle Arts
Personal Development
 Citizenship
 Communication
 Leadership
 Self Determined
Science, Engineering, & Technology
 Mechanics
 Woodworking
 Science, Engineering &
Technology
Agriculture & Natural Resources
 Crop Production
 Environment & Sustainability
 Horticulture
 Outdoor Adventures
 Safety & Education in Shooting
Sports
Special Awards (9th Grade & Above Only)
 Achievement
 Agriculture
 Citizenship
 Leadership
State 4-H Recognition
Project Award
Application Cover Sheet
Personal Information (Click on line or in box to type information)
PROJECT NAME
Name
Years involved in 4-H program
Address
City
Phone
Ext. Region #
Current Year in School
IA
Zip Code
County
E-mail Address
Age
Birth Date
Parent(s)/Guardian(s)
1. Complete application = Cover Sheet; application question responses—not more than two (2) pages;
and two (2) pages of support material.
2. The questions and support material are different for each opportunity for which you are applying.
3. You may use up to two (2) pages to answer the five (5) questions that follow related to this opportunity.
4. You may attach two (2) additional pages of support material related to this opportunity.
 May be a story, resume, records or a portion of a record, photos, etc.
 Format: 8 1/2" x 11", one sided, 12-point font recommended.
5. Submit the original and 3 copies of your total application (include this cover sheet, 2 question response
pages, and 2 support material pages for no more than 5 total pages.
 Four (4) sets total.
 No folders, sheet holders, or binders please.
 Staple or clip written material.
6. Send ALL application materials by February 1 (received or postmarked) to:
4-H Recognition, Extension 4-H Youth Bldg-ISU, Ames IA 50011-3630
October 2012, State – 28 – Project 2
County & State 4-H Project Award Application Questions
Name
Project
You may use up to two (2) pages, no more, to answer the following five (5) questions. Boxes should expand as
you type.
4-H Project Award Application Questions
1. What skills and knowledge have you gained in your 4-H project? Include goals, plans, and growth
of your project. Share your own personal growth connected to your work in this project over the
years.
2. How have you shared your project knowledge with others?
3. What is leadership to you? Highlight specific opportunities you have had within this project area
and any other elected or voluntary leadership you have taken on locally or beyond.
4. Share how your 4-H participation, individually or as part of a group, has met the needs of others.
5. How do you think your 4-H project experiences will affect your future?
[You may attach two (2) additional pages of support material.]
Iowa State University Extension programs are available to all without regard to race, color, age, religion, national origin, sexual orientation, gender
identity, genetic information, sex, marital status, disability, or status as a U.S. veteran. Inquiries can be directed to the Director of Equal Opportunity and
Compliance, 3280 Beardshear Hall, (515) 294-7612.
Issued in furtherance of Cooperative Extension work, Acts of May 8 and June 30, 1914, in cooperation with the U.S. Department of Agriculture. Cathann
A. Kress, director, Cooperative Extension Service, Iowa State University of Science and Technology, Ames, Iowa.
October 2012, State – 28 – Project 3