clark.uwex.edu · Web view2018 Award Packet . Clark County 4-H Youth Award Forms: Cloverbud...

2018 Award Packet Clark County 4-H Youth Award Forms:

Cloverbud Achievement (Ages 5 to 7 as of January 1) Leader Completes

Younger Youth Achievement (Ages 8 to 10 as of January 1) Leader Completes Intermediate Youth Achievement (Ages 11 to 13 as of January 1) (Youth completes/Leader Recommend)

Youth Achievement (Ages 14 – 19 as of January 1) (Youth completes/Leader Recommend)

Youth Citizenship (ages 14 to 19) (Youth completes/Leader Recommend)

Youth Leadership (ages 14 to 19) (Youth completes/Leader Recommend)

4-H Fair Project Bonus Award (grades 3rd to 13th) (Youth Completes)

Clark County 4-H Awards 4-H Alumni Remarkable 4-H Club (Club Officers completes)

Remarkable 4-H Adult Volunteer Leader Friend of 4-H

You can find these forms in their individual form in a word document or PDF at: http://clark.uwex.edu/4-h-youth-development/club-and-county-awards/

Other Awards Not Found in this Packet Outstanding 4-H Record Book Award Secretary’s Book Treasurers Book Club Scrapbook

You can find these forms in a word document or PDF at:http://clark.uwex.edu/record-book-evaluation-procedure/ or contact the UWEX office to mail you copies 715-743-5121.

You can complete these forms online and email to [email protected] or print the form and complete and mail to UWEX Office

Attn: Lori Hendrickson517 Court Street, Room 104Neillsville, WI 54456

Submission is the only way to win, do not delay submit today!

mailto:[email protected]

http://clark.uwex.edu/record-book-evaluation-procedure/

http://clark.uwex.edu/4-h-youth-development/club-and-county-awards/

Cloverbud Achievement Award Application Form (Ages 5 to 7 as of January 1) Due September 15

Complete application ONLY IF RECORD BOOK HAS BEEN TURNED IN. Leaders complete application. If parent is the leader, please find another leader in your club to complete the form. Place nomination inside record book when submitting.

Name of Nominee: ___________________________________________ Age (January 1): ______ Grade (current year): ______

Address: ____________________________________ City: ______________________ Zip: ___________________

Phone or Email: _______________________ 4-H Club: ____________________________ Attend 50% club Mtgs. Y N

Projects Exhibited at the FairProject Areas # of Years

Cloverbud Simple art item 1

Participation in Club Activities (e.g. Community Service, etc.)Club Activities Year

Club Demonstrations or SpeechPresentation(s) Year

Read “Cat in the Hat” 2017

Participation in County Activities (Drama & Music Festival, Volleyball, Softball, Bowling, Sledding, Foods Revue, Camps...)County Activities Year

Why are you nominating this youth for Cloverbud Achievement? Certify this applicant is in good standing.

Club Leader Nominating: ___________________________ Signature: ___________________________ (use back if necessary)

Younger Youth Achievement Award Application Form (Ages 8 to 10 as of January 1) Due September 15

Complete application ONLY IF RECORD BOOK HAS BEEN TURNED IN. Leaders complete application. If parent is the leader, please find another leader in your club to complete the form. Place nomination inside record book when submitting.


Address: ____________________________________ City: ______________________ Zip: ___________________



Exploring Rock Creature 3

Participation in Club Activities (e.g. Community Service, etc.)Club Activities Year

Club Demonstrations or SpeechPresentation(s) Year

Read Selection from “Horton Hears a Who!” 2017

Participation in County Activities (Drama & Music Festival, Volleyball, Softball, Bowling, Sledding, Foods Revue, Camps...)County Activities Year

Why are you nominating this youth for Younger Youth Achievement? Certify this applicant is in good standing.


Intermediate Youth Achievement Award Application Form (Ages 11 to 13 as of January 1) Due September 15

Complete application ONLY IF YOU TURNED IN YOUR RECORD. Youth completes this application. The leader completes recommendation section. If parent is the leader, please find another leader in your club to complete the section. Place nomination inside record book when submitting.


Address: ____________________________________ City: ______________________ Zip: ___________________



Example: Vet Science 4

Club Demonstrations or Speeches conducted related to the topicPresentation(s) Year

Demonstrated Ear Tagging Calves 2017

Participation in County Activities (e.g. Junior Leaders, Speaking & Demonstration, Camp, Volleyball, Sledding, Bowling…) County Activities Year

Participation in State and other activities (Wisconsin In-State Trip, Inter-state, Washington DC, etc.)State/Other activities Year

Leader Recommendation Section: Explain your approval of this nomination and certify this applicant is in good standing.


Youth Achievement Award Application Form (Ages 14 – 19 as of January 1) Due September 15

Complete application ONLY IF RECORD BOOK HAS BEEN TURNED IN. Youth completes the application. If parent is the leader, please find another leader in your club to complete the recommendation. Place nomination inside record book when submitting.


Address: ____________________________________ City: ______________________ Zip: ___________________


Projects TakenProject # of Years

Example: Cultural Arts 6

Special Awards Received for Project Award Project Club County/State YearExample: Award of Excellence Cultural Arts - Drawing X 2017

Special Awards Received for Activities Award Project Club County/State YearExample: State Fair Nomination Vet Science – Poster Display X 2017

Club Demonstrations or Speeches conducted related to the topicPresentation(s) Year

Demonstrated Cat welfare check 2016

Participation in County Activities (e.g. Junior Leaders, Speaking & Demonstration, Camp, Sledding, Volleyball, Counselor...)

County Activities Year

Participation in State and other activities (Wisconsin In-State Trip, Inter-state, Washington DC, etc.)State/Other activities Year

What have you gained by participating in the activities / projects listed on the previous page?

Share leadership opportunities you took part in and shared with your club or county from your involvement in these activity / project areas? Example Facilitated Drawing activity at Discovery Day.

How have your shared your knowledge with cloverbuds and explorers in your 4-H club?

Leaders Recommendation: Explain your support of this nomination and certify this applicant is in good standing.

Signature of Club Leader: _________________________________________Youth Citizenship Award Application Form

(Ages 14 – 19 as of January 1) Due September 15

Complete application ONLY IF RECORD BOOK HAS BEEN TURNED IN. Youth completes the application. If parent is the leader, please find another leader in your club to complete the recommendation section. Place nomination inside record book when submitting.


Address: ____________________________________ City: ______________________ Zip: ___________________


Please list community service projects youth participated in with your 4-H club. Club and/or Group Accomplishment Year

Example: Raking Leaves Elderly Homes in area 2017

If you need more boxes continue on separate piece of paper.

1. What do you bring to service projects you participate in and/or plan?

2. What have you shared with younger members in your club about citizenship?

3. What growth have you seen through your participation in citizenship/community service activities with your club?

(Leader completes back side)Leader Recommendation: Explain why you approve of this nomination and certify this applicant is in good standing.

Club Leader Nominating: ________________________________________

Youth Leadership Award Application Form (Ages 14 – 19 as of January 1) Due September 15

Youth completes this application which ACCOMPANIES THEIR RECORD BOOK. The leader completes recommendation section. If parent is the leader, please find another leader in your club to complete the recommendation. Place nomination inside record book when submitting.


Address: ____________________________________ City: ______________________ Zip: ___________________


Offices held and number of years in a position Check all that apply

Position Held Club County District State Year(s)Example: Camp Counselor 2 2016, 2017

Lead Facilitator of Committee(s) or County Commitments Name of Committee Purpose of Committee Year(s)

Example: Discovery Day Facilitator Taught K to 6 graders to make sun catchers 2017

Community Service Projects Community Service Purpose of Service Year(s)

Example: Family Fun Festival Promote 4-H to youth and get them involved in the community 2016

1. Share your leadership within your club (leading recreational games at meetings, etc.):

2. Explain your participation at the County level with Junior Leaders, Summer Camps, Coaching, etc.

3. How have you grown by taking on more responsibility within the club and county 4-H program?

4. Leader Recommendation Section: Explain your approval of this nomination and certify this applicant is in good standing.

Signature of Club Leader: ________________________________ 4-H Fair Project Bonus Application Form

Successful applicant in each age category will receive an additional $125This award is possible through a generous and continuous donation from an individual’s paycheck on a quarterly basis.

You are eligible for this award if you take what you signed up to takeDue September 15

Select your grade group: ___ 3rd to 5th ___ 6th to 8th ___9th to 11th ___ 12th to age out

Youth completes this application. The focus of this award is acknowledging an individual who fulfills their commitment to the number of projects selected prior to July 1 and the number exhibited at the fair. This application MUST accompany your complete RECORD BOOK.

Name: ________________________________________________________ Age (January 1): ______ Grade (current year): ______

Address: ____________________________________ City: ______________________ Zip: ___________________

Phone or Email: _______________________ 4-H Club: ____________________________ Attended 50% club Mtgs. Y N

We want to reward members who set goals and plan ahead, rather than signing up for a multitude of exhibits and seeing what they have by the end of summer.

EXAMPLEDepartment / Class / Lot # Project Description Exhibited Record Book

RecordSewing B 2 Vest Yes YesFlowers Houseplants E 6 Wreath natural material Yes YesWood Working A 6 Shelf No Yes

Department / Class / Lot # Project Description Exhibited Record Book Record

Department / Class / Lot # Project Description Exhibited Record

The following questions will be reviewed in your record book for thoroughness: What are your goals for this project Exhibits Description Types of Materials/Supplies or Equipment Used Summary of your project work

Note: If you did not complete a project, you can still fill out a record book page and explain the situation that prevented you from completing all your projects (life happens).

Please explain why you should receive the $125 bonus over your peers who have submitted this application?

Leader Section: Explain your approval of this nomination and certify this applicant is in good standing. Club Leader: __________________________________________ Signature: ________________________

REMARKABLE 4-H ADULT VOLUNTEER LEADER AWARD NOMINATION FORMDue September 15

This award is presented to an adult 4-H volunteer leader that has contributed a great deal to the Clark County 4-H program; through club, committee, and county contributions positively representing Clark County 4-H.

Nominee’s Name: ___________________________________________________________________________________

Address: ____________________________________ City: __________________________ Zip: ____________________

Phone/Email: _______________________________________ 4-H Club: _______________________________________

Describe examples of this individual’s commitment to Clark County 4-H:

Signature of individual(s) completing nomination form: _______________________________________________________

Remarkable 4-H Club Award Nomination FormDue September 15 (unable to win 2 consecutive years)

This form must be completed by 4-H club officers

Name of Club: ________________________________________________________________________

Number of Members: _____ Number of Families Involved: ______ Number of Leaders Involved: _______

Number of Youth Leaders Involved: ______ Youth Nominators: __________________________________

Number of club meetings held from October 1 to September 30: ___________________

Information must be limited to the most current 4-H year just completed and must fit on these 2 pages.

CLUB INVOLVEMENTA. List events/activities the club participated in this year?

B. What was the activity/event that had the most club participation?

C. Why did so many members attend?

D. How could you involve more families in future events/activities and how can you make other events as popular?

COMMUNITY INVOLVEMENT/COMMUNITY SERVICE

A. List specific events/activities involving the community or for the community?

B. How was the community involved or served?

C. What was the visible effect within the community from the events/activities?

CLUB MEMBER INVOLVEMENTDid each member participate in at least one event? __ Yes __ No

NO ADDITIONAL PAGES / SCRAPBOOKS / EXTRA MATERIALS ALLOWED.

Nominating Club President: ____________________________ & Secretary: ______________________

Friend of 4-H Award Nomination FormDue September 15

This award is presented to an individual, couple, group, business, or service organization that has contributed in kind or financially to the Clark County 4-H program over a period of time. Recommendations could include re as follows:

Volunteered time and talents with 4-H club and within the County 4-H program Worked collaboratively with club/county 4-H to create something Contributed in a variety of ways to the club and county 4-H program

Nominee’s Name/Company:____________________________________________________________________________

Address: ____________________________________________ City: _____________________________ Zip: ________

Phone/Email: ____________________________Nominating Individual or 4-H Club: ______________________________

Nominated by: _____________________________________________________________________________________

What and how has this entity contributed to the Clark County 4-H program?

Signature of individual(s) completing nomination form: _____________________________________________________

4-H ALUMNI NOMINATION FORMDue September 15

The 4-H Alumni Award is presented to one individual who is a past 4-H member and are currently active as a 4-H volunteer. They will be recognized for the current outstanding accomplishments and dedication to 4-H.

Assistance within the club leading project areas or sub-committee groups Participation on the county level with the Leaders Federation or county committees, etc.

Nominees Name: __________________________________________________________________________________

Address: _________________________________________ City: ______________________ Zip: __________________

Phone/Email: ___________________________________________Number of years as a 4-H Member: ___________

Name of Club/County which alumni member was enrolled: ___________________________________________________

Nominated by (Club Name): ___________________________________________________________________________

Describe the contributions of the person nominated (assistance on club/project level or at a county level):

Signature of individual(s) completing this nomination form: ___________________________________________________

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