Howard County 4-H
Record Keeping Awards Application and Evaluation Form
For Intermediates and Seniors
Please complete this form and place on the top of your 4-H record keeping forms. Indicate for which awards you are
applying. A complete list of awards is on the back of this page. This application reflects your past year’s 4-H work.
Member’s Name: ___________________________________ Club: _______________________________
“X” One: _____ Intermediate (7th-8th grades last year) _____ Senior (9th-12th grades last year)
I wish to received _____Top Intermediate Record Book Award or _____Top Senior Record Book Award.
__________I wish to receive reading Award.
I am applying for the following awards: _______________________________________________________
_______________________________________________________________________________________
Requirements for submitting record books:
 Complete record book in suggested order
 Livestock project area records must include 4-H
market/breeding animal worksheets to show feed
 Complete and demonstrate competency in at least
rations, vet care, and cost analysis.
one project record.
 Submit record books to Extension Office by
 Submit current year plus up to two previous years’
September 1st.
records, especially for those project areas in which
you are applying for an award.
 See back of this form for additional information on
Overall Senior Achievement Awards.
 May receive each project award only once as an
 See back of Expected Standards for suggested
intermediate and once as a senior.
record book order.
Record Keeping Evaluation Form
To be completed by Record Keeping Review Committee
E=Excellent
G=Good
NI=Needs Improvement
I=Incomplete
50% or more of Excellent and Good ratings warrants receipt of respective project award.
_____________ Project
Organization and
E
G
NI
I
E
G
Appearance
ART Goals are used:
Record book in suggested
order
Records neatly done
Member reflects how
learned skills can be used in
the future
Support material present
NI
I
Member reflects how
learned skills can be used in
the future
Support materials present
Yearly Summary complete
ART Goals are used:
Action, Result, Timetable
Member shows progress
toward meeting goals
Costs of project shown
I
Action, Result, Timetable
Member shows progress
toward meeting goals
Costs of project shown
Proper spelling and
grammar
Cover page complete
Completed at least one
project record
Support information neat
and orderly
Evidence of
communications activity
Evidence of service or
leadership activity
_____________ Project
NI
_____________ Project
ART Goals are used:
Action, Result, Timetable
Member shows progress
toward meeting goals
Costs of project shown
E
G
NI
I
Member reflects how
learned skills can be used in
the future
Support materials present
Overall Comments:
Member Recommended
for the following awards:
E
G
List of Record Keeping Awards and Definition of Terms
Intermediates and Seniors may apply for the following awards (please list on front of this page):
Recognition (certificate)—available for members choosing not to apply for a project award or for members
who have already received all project awards for which they are interested at their age level.
Intermediate and Senior Project Awards (medals):
Aerospace
Ag & Natural Res.
Astronomy
Automotive
Beef
Bicycle
Camping
Child Development
Citizenship
Clothing
Communications
Computer
Consumer Mgmt
Crop Production
Dairy Cattle
Dairy Goat
Dog
Electric/Electronics
Entomology
Environment
Fashion Review
Food & Nutrition
Forestry
Health
Home Improvement
Horse & Pony
Hort/Garden
Leadership
Music
Pets
Photography
Plant Science
Poultry
Rabbits
Recreation
Robotics
Safety
Science & Tech
Self-Determined
Sewing/Needle Art
Sheep
Shooting Sports
Small Engine
Sport Fishing
Swine
Tractor
Vet Science
Visual Arts
Wildlife
Welding
Woodworking
Overall Senior Achievement Awards (Requires submission of record book and an interview. May apply for three):
Award
Achievement in 4-H
Experience
Agriculture
Ak-Sar-Ben
Lamp of Knowledge
Achievement in
Citizenship
Achievement in
Leadership
I Dare You Award
Awards Trip
Description
Attain knowledge of 4-H programs and contribution to
improve family and community living
Develop knowledge and respect for agriculture and its
importance to communities (i.e. crops, livestock, foods,
gardening, etc.)
Outstanding leadership in a variety of 4-H activities
Grades
9th - 12th last year
You will receive…
Medal
9th - 12th last year
Medal
9th - 12th last year
Medal
Contribution to 4-H through leadership, citizenship, and
overall dedication to the 4-H program.
Demonstrates social responsibility, respect, and
responds to the needs of others
Strengthens local 4-H clubs in leadership,
responsibilities, and encouragement of other youth
Awarded to two youth who exemplify personal
integrity, balanced living, and motivation for leadership
9th – 12th last year
Medal
9th - 12th last year
Medal
9th - 12th last year
Medal
10th or 11th last year
Book
Awarded to eight youth for overall quality record
keeping.
9th - 11th last year
3-day trip in June
Definition of Terms
Local = your 4-H Club
Area = involves 4-Hers from neighboring counties
County = involves other Howard County 4-Hers
State = involves 4-Hers 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.