DELAWARE 4-H RECORD
GENERAL INFORMATION
Name: _________________________ Age as of January 1, 20 _____
_____ years old
Complete Address: _________________________________________________________
Town/State/Zip Code: _______________________________________________________
Number of years in 4-H (Including this year): ______
School Grade: ______
Name of Club: _______________________________________
Years Enrolled ~ Project Summary (Include all projects for all years)
Example:
Foods
3 Years
2008-2010
I have personally prepared this report and believe it to be true and accurate.
Date: ________
Signature of Member _______________________________________
Date: ________
Signature of Parent/Guardian _______________________________
Date: ________
Signature of 4-H Leader ____________________________________
SPECIAL INSTRUCTIONS:
When presenting information on the following pages,
BE BRIEF in the various sections of this book, and
respond in the form of a numbered list,
not in paragraph form.
1
LOCAL CLUB OR GROUP RESPONSIBILITIES --- THIS YEAR
Number of members in your club: _____ Regular Members: _____
Cloverbud Members: _____
Number of business meetings held by your club starting from September 1: _____
How many meetings did you attend? _____
List 4-H Offices you held and the committees you served on:
Office or Committee
Your Responsibilities
List participation in club meetings for this year. For example: Gave a demonstration, led the pledge,
taught a game, gave a committee report, helped clean up after meeting, arranged meeting room, etc.
CITIZENSHIP / COMMUNITY SERVICE EXPERIENCES
List citizenship and community service experiences that you have had this year only.
Total Community Service Hours_____
2
PARTICIPATION IN 4-H PROGRAMS/ ACTIVITIES (Check All You Participated In)
County Events:
National 4-H Week
Achievement Banquet
County Demonstration Day
Younger Member Weekend
Junior Leader Weekend
Public Speaking Contest
4-H Summer Day Camp
County Clothing/Textile Showcase
____
____
____
____
____
____
____
____
County Window Display
Junior Council Meetings
Great Pumpkin Day
Compact Tractor Driving
Exchange Group
Favorite Foods Contest
4-H Science Camp
County Sewing Contest
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
State Record Book Training
Club Officer Training
Public Speaking Training
Poultry Judging Training
Horse Judging Training
Wildlife Judging Training
Horticulture Judging Training
Dairy Judging Training
____
____
____
____
____
____
____
____
____
____
____
____
____
Poultry Judging Contest
Photography Judging Contest
Horticulture Judging Contest
Clothing Judging Contest
Livestock Judging Contest
____
____
____
____
____
____
____
____
____
____
____
____
Equine Arts Contest
Cow Camp
4-H State Teen Conference
Livestock Exposition
National 4-H Dairy Conference
National 4-H Conference
____
____
____
____
____
____
____
____
____
____
____
State Demonstration Contest
State Public Speaking Contest
4-H Lawn Tractor Driving
4-H Archery Competition
Total Entries Submitted
____
____
____
____
____
Trainings:
Favorite Foods Contest Training
County Record Book Training
Demonstration Contest Training
Day Camp Counselor Training
Photography Judging Training
Horticulture Judging Training
Livestock Judging Training
Woodworking Judging Training
Judging Contests:
Dairy Judging Contest
Woodworking Judging Contest
Foods Judging Contest
Wildlife Judging Contest
Horse Judging Contest
Other Events:
State Environmental Camp
State 4-H Camp
Holiday Ice Skating Party
State Horse Bowl Contest
4-H Legislative Day
National 4-H Congress
PQA Training
Delaware State Fair
State Judging Contests
State Talent Show
4-H Consumer Bowl
4-H Tractor Driving
4-H Avian Bowl
3
Kent County Events:
County Litter Barrel
County Livestock/Jackpot Show
County Trim a Tree
Holiday Fun Day
Share The Fun Talent Show
Winter Fun Day
St Patrick’s Day Parade
Photography Contest
Kent County 4-H Horse Show
County Science Club
County Robotics Club
____
____
____
____
____
____
____
____
____
____
____
Cloverbud Fun Day
Pygmy Goat Show
Teddy Bear Drive
International Foods
Livestock Overnighter
Livestock 101 Social
Old Dover Days Parade
Basket Auction
4-H & FFA Spring Dairy Show
County Tech Team
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
____
Coastal Clean Up
____
County Robotics Club
____
Younger Member Fall Retreat ____
4 Little Clovers Talent Show ____
Computer/Graphic Arts Contest ____
Holiday Cards for Soldiers
____
Sussex County 4-H Horse Show ____
____
____
____
____
____
____
____
____
Winter Workshops Attended:
_____________________
_____________________
_____________________
_____________________
_____________________
_____________________
Sussex County Events:
Pedal Pusher Bike Rides
County Archery Training/Shoots
Pumpkin Contest
International Foods
Photography Contest
Winter Fun Day
Hopkins Farm Tour
New Castle County Events:
NC County Livestock Show
Younger Member Fun Day
Quest for the Clover 5K
Shooting Sports Day
Food Bank Collection
AG Day
Holiday Clothing Drive
Ronald McDonald House Kit
4
_____
_____
_____
_____
_____
_____
PARTICIPATION IN LOCAL CLUB EVENTS
List activities and events that you participated in at the club level. Do not duplicate events that
have already been reported in other sections on this form.
CLUB, COUNTY and/or STATE 4-H LEADERSHIP EXPERIENCES--THIS YEAR
(NOTE: Do Not Complete this Section for Exploring 4-H Books)
1. Are you a member of the County Junior Council? ______ Number of meetings attended: ____
2. List your leadership participation in the county or state program. (Example: Member of
planning committee, MC, Sold Ads for County Horse Show, host/hostess in 4-H Building, etc.)
3. Are you a Junior Leader? _____ What are your responsibilities in your club or on the
county level?
5
4. How have you assisted other members in your club or on the county or state level?
5. List other leadership experiences you have had this year in 4-H.
EXPERIENCES AND AWARDS OUTSIDE OF 4-H
List and explain important things, other than 4-H, that you have done in school, church, or other groups
in your community, county, or state.
6
DOCUMENTING YOUR PROJECT
Use this page to record more detail about your general 4-H year. Use pictures, samples, etc.
Do not shingle or overlap items. You may add one additional page for a total of 2 pages for
this section. You are permitted to have photos on the front and back of each page.
7
MY 4-H STORY
Include a narrative of the past year’s 4-H work that describes your successes, failures, and
experiments. This writing should not exceed 500 words.
8