Polk County 4-H
Project Award
Application Cover Sheet
Personal Information (Click on line or in box to type information)
Years in Project
PROJECT AREA
Name
Years involved in 4-H
Address
City
IA
Phone
Zip Code
County
Extension Region #
13
2014-2015 Year in School
E-mail Address
Age
Birth Date
Parent(s)/Guardian(s) Name(s)
Interview Preference Time (please X one):
Thursday, October 15, 2015
Tuesday, October 20, 2015
I have a conflict on both dates. Please contact Katie Beary at kbeary@iastate.edu or 515-9575771 to schedule an alternate interview or time/method.
My conflict is:
Please consider the following when scheduling my interview(s):
Project Award
4-H'ers can receive four project awards per year.
4-H'ers can receive county recognition in a project area only one time per age division/class i.e. Junior.
1. Complete application = Cover Sheet; Application (not more than two pages); and up to two pages of
Supplemental Information.
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 are related to this opportunity.
4. You may attach two (2) additional pages of Supplemental Information 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 one copy of your complete application
 Two sets total (each complete application will be no more than five pages)
 No folders, sheet holders, or binders please.
 Staple or clip written material.
6. Submit by 12:00 pm on October 1 to:
ISU Extension, c/o Katie Beary, 1625 Adventureland Drive, Ste. A, Altoona, IA 50009
7/30/15 Project
4-H Project Award Application Questions
Name
Project
You may use up to two 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 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.
7/30/15 Project