Major Senior Awards Application Form
(including Outstanding Senior, Senior Family & Consumer Science, Senior Ag & Natural Resources & Senior Science, Mechanics & Engineering)
Objective: To Recognize 4-H Members for Personal Growth and Development
You may complete one application form to apply for all major awards.
PLEASE RETURN TO THE EXTENSION OFFICE BY SEPTEMBER 15TH (with your record book)!
Name _______________________________
Phone Number ______________________
Number of years in 4-H ___________
Grade Just Completed ________________
Club __________________________________
Today’s Date _______________________
Awards for which you are applying: (Circle all that apply)
Outstanding 4-Her: Senior
Listed below is the criterion for each area of the Outstanding 4-H’er Awards you may qualify
for. 4-H’ers are expected to have completed ALL described requirements on application under
appropriate age level during the age for which they are applying. You may receive each award
only once.
Outstanding Senior (10th, 11th, or 12th grade completed)

Participated in interview with volunteer to review record keeping system
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Currently enrolled in 4-H in at least three projects
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At least one Communication experience at local level
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At least one Communication experience at County level
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At least one Communication to a non-4-H audience
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At least one Leadership experience at County level
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At least one Leadership experience with non-4-H audience
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At least one Citizenship experience at County level
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At least one Citizenship experience with non-4-H audience

Actively participated in club activities other than month meetings
Family & Consumer Sciences:
Senior
Ag & Natural Resources:
Senior
Science, Mechanics & Engineering:
Senior
4-H Activities: _______________________________________________________________________
____________________________________________________________________________________
Non 4-H Activities: ___________________________________________________________________
____________________________________________________________________________________
Complete this form and attach it to:
Support Material: (not more than 3 pages) to show progress toward superior quality
skills. This support material may be anything that supports your application (i.e. record inserts, photos,
clippings, resume, portfolio, etc.) A different set of support material may be presented relating to each
award for which you are applying. Members may apply for more than one award. Member may receive
each County Award once.
2.
Yearly 4-H Summary or Story
Please tell us about the life skills (such as leadership, citizenship, management, etc.) that you
have learned in 4-H. How you apply or will apply these skills in everyday life?
1.
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Member: Return this form, your support material and your completed record book to your club leader.
You will be contacted for interviews at a later date.
Leader: Please verify that all support material is in order by signing this form and returning it and the
support material to the member or Extension Office. Record books are required to be turned in to us,
but can be turned in separately by the 4-H’er. Applications are due September 15, 2015 by 4:30 p.m.
4-H Member’s Signature _________________________________________ Date _________________
Leader’s Signature ______________________________________________ Date _________________
Award Descriptions
Family and Consumer Science Awards recognize those who have been outstanding in the home and
family related topics including Child Development, Clothing, Consumer & Management, Food &
Nutrition, Home Improvement, Creative Arts, Personal Development, Posters and Photography. This
award will be given to one 4-H’er in each level of 4-H and may not be received by a 4-H’er more than
once per 4-H level (Jr, Int, Sr).
Agriculture and Natural Resource Awards recognize those who have participated in a variety of
agricultural projects and programs including Animal Science, Veterinary Science, Crop Production,
Environment & Sustainability, Horticulture, Outdoor Adventures, Safety & Education in Shooting
Sports, Other Ag & Natural Resources. This award will be given to one 4-H’er in each level and may
not be received by a 4-H’er more than once per 4-H level (Jr, Int, Sr). The Senior-level award recipient
will have their name added to the Howard “Swede” Strasser Memorial Plaque and will receive a savings
bond from the Strasser Family.
Science, Mechanics, and Engineering Awards recognize those who have participated in a variety of
science & technology projects and programs including Digital Storytelling, Mechanics, Woodworking,
Science, Engineering & Technology. This award will be given to one 4-H’er in each level and may not
be received by a 4-H’er more than once per 4-H level (Jr, Int, Sr). The Senior-level award recipient will
have their name added to the Homer D. Gay Memorial Plaque and will receive a savings bond from the
Gay Family.
Merit Award
Name ________________________________ Years in 4-H _____
Club _____________________________ Grade Just Completed
______
In 2 pages or less, please describe how you have grown through your 4-H
experience in citizenship, community & club leadership at a local/club level.
Include…
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A listing of your citizenship and leadership roles and activities
How these activities have helped you grow as a person
How your citizenship and leadership have helped your community and
club
Leadership Award
Name ________________________________ Years in 4-H _____
Club _____________________________ Grade Just Completed
______
In 2 pages or less, please describe how you have shown excellent leadership
skills. Include…



A listing of your leadership activities in your club, county, and projects.
What your leadership has helped accomplish.
What you have learned about being a leader and how this will help you in
the future.
Achievement Award
Name ________________________________ Years in 4-H _____
Club _____________________________ Grade Just Completed
______
In 2 pages or less, please describe how you have grown through participation
in a variety of 4-H projects and activities, including…


A listing of the 4-H projects in which you would have been involved and
what you have learned from your involvement in these projects (growth is
best shown through goal setting and achievement of goals, rather than
fair exhibition ribbons)
Activities you have been involved in throughout your years in 4-H and
how these activities have helped you grow as a person. Include any
leadership and citizenship roles in which you may have participated.
Citizenship Award
Name ________________________________ Years in 4-H _____
Club _____________________________ Grade Just Completed
______
In 2 pages or less, please describe how you have shown excellent citizenship
skills. Include…



A listing of your citizenship activities in your club, county, and projects.
What your citizenship has helped accomplish.
What you have learned about being involved in the community and how
this will help you in the future.
William H. Danforth “I Dare You” Award
Name ________________________________ Years in 4-H _____
Club _____________________________ Grade Just Completed
______
**Must have completed 11th or 12th grade to be eligible for this award**
William H. Danforth, founder of Ralston Purina, wrote the book “I Dare You”
from his personal experience. He challenged young people to their highest
potential in service and good citizenship. The Danforth “I Dare You” Award
recognizes youth who have an in-depth knowledge of the 4-H program.
It is to challenge them to develop their skills for future endeavors through life
and most importantly service to others.
In 2-3 pages, please describe how you have shown excellent leadership skills.
Include…



how you have been involved with 4-H at various levels (club, county, area,
and/or state) and the variety of experiences you have encountered.
how 4-H has helped you to reach your potential
how you will use the skills that you have learned and acquired in 4-H in
your future endeavors.