Record Keeping Evaluation Form
Due to the Extension Office by September 30!
Record book in suggested
order
Records neatly done
Please complete this form and turn in to the office with
member’s record book. Indicate for which awards you are
applying.
Proper spelling and
grammar
Cover page complete
Yearly Summary complete
Member’s Name: ______________________________
Club: _________________________ Date: _________
Member is applying for the following awards:
 _____ Recordbook Completion
 _____ Project Award(s) (list all):
Completed at least one
project record
Support information neat
and orderly
Evidence of
communications activity
Evidence of service or
leadership activity
Project: __________________
Requirements for submitting record books:







Complete record book in suggested order. See back of
Expected Standards for suggested record book order.
Complete and demonstrate competency in at least one
project record.
Submit current year plus up to two previous years’ records,
especially for those project areas in which you are
applying for an award.
May receive each project award only once as an
intermediate.
Livestock project area records must include 4-H
market/breeding animal worksheets to show feed rations,
vet care, and cost analysis.
Submit record books to Club Leader by September
meeting. Leaders must submit award information to
Ext. Office by September 30.
See back of this form for additional information on and
definition of terms.
ART Goals are used:
Action, Result, Timetable
Member shows progress
toward meeting goals
Costs of project shown
Member reflects how
learned skills can be used in
the future
Support material present
Project: __________________
ART Goals are used:
Action, Result, Timetable
Member shows progress
toward meeting goals
Costs of project shown
Member reflects how
learned skills can be used in
the future
Support materials present
Project: __________________
Overall Comments:
ART Goals are used:
Action, Result, Timetable
Member shows progress
toward meeting goals
Costs of project shown
Member reflects how
learned skills can be used in
the future
Support materials present
Member Recommended
for the following awards:
Revised August, 2009
Incomplete
Needs
Improvement
Good
Organization and
Appearance
Excellent
To be completed by Club Leaders or Volunteers
Butler County 4-H
Record Keeping Awards Application and
Evaluation Form
For Intermediates and Seniors (7-12th)
List of Record Keeping Awards and Definition of Terms
Intermediates may apply for the following awards (please list on front of this page):
Intermediates will receive a Project Certificate. Project Awards can only be received once as an
intermediate. Members must be enrolled in the project area in order to receive an award.
Aerospace
Automotive
Beef
Bicycle
Child Development
Citizenship
Clothing
Communications
Consumer Mgmt
Crop Production
Dairy Cattle
Dog
Electric/Electronics
Entomology
Environment
Food & Nutrition
Forestry
Goats
Health
Home Improvement
Horse & Pony
Horticulture
Leadership
Music
Outdoor Adventures
Pets
Photography
Plant Science
Poultry
Rabbits
Robotics
Safety
Science & Tech
Self-Determined
Sheep
Shooting Sports
Small Engine
Sport Fishing
Swine
Tractor
Vet Science
Visual Arts
Welding
Wildlife
Woodworking
Definition of Terms
Local = your 4-H Club
County = involves other Allamakee County 4-H’ers
Area = involves 4-Hers from neighboring counties
State = involves 4-H’ers from all counties in Iowa
Citizenship/Service refers to helping others or working for the benefit of others or the community for no pay. The primary goal is
to benefit someone else. On the club level citizenship examples might include: host a meeting, lead pledges, serve on a committee,
work on club service project or fund raising, 4-Hers for 4-H donation, National 4-H Week Promotion.
Communication is writing, talking to, or showing others in order to share ideas, knowledge, or skills. Club communications
examples could include: answering roll call, club presentations, making posters to promote a club fund raiser, community service
project, etc.
Revised August, 2009