Clover Achievement Award
Name: _____________________________________
Age: _______________
Club: ______________________________________
County: ____________
To achieve the Clover Achievement Award you must have completed the 4th grade and
have participated in a Union County 4-H Club. In addition you must have completed all
the mandatory items listed below and two of the optional requirements. Check the
column at the left with your completed items.
Mandatory Requirements for Clover Achievement Award
___
___
1. Attend half of your club meetings. If you have joined during the year, the
majority of the meetings will be based upon the number of meetings remaining
following your joining the club.
___ Number of meetings you attended.
___ Number of club meetings.
2. Completed your record book and submitted for record book judging.
Optional Requirement for Clover Achievement Award
4-H strives to instill “Life Skills” in young people, skills that will build their confidence
and abilities which will benefit them now and into the future. There are four categories
of identifiable life skills:
1. Giving and Working
3. Managing and Thinking
2. Relating and Caring
4. Living and Being
4-H members applying for the Clover Achievement Award are required to complete two
of the optional requirements listed below.
Giving and Working
___ 1. Participated in a club activity.
List and describe the activity and your experience:_________________________
__________________________________________________________________
__________________________________________________________________
___ 2. Participated in a county activity.
List and describe the activity and your experience: _________________________
__________________________________________________________________
__________________________________________________________________
___ 3. Participated in a club service project.
List and describe the activity and your experience:_________________________
__________________________________________________________________
__________________________________________________________________
The above information is correct.
Signed: __________________________________________
Date: _____________
Club Leader Signature: ______________________________
Date: _____________
4-H Youth Coordinator Signature:______________________
Date: _____________
For Selection Committee Use Only:
________ Approved
_______ Deferred
Date: ____________
Comments: _____________________________________________________________
_______________________________________________________________________