Member Evaluation
Name
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Address
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Phone Number
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Email
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Name of Parent or Guardian
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Age
Grade
Club
Please check any of the following trips that you have attended/award you have recieved
Future plans
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Please list the projects you are enrolled in and how many years you have been enrolled in the project.
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4-H Leadership
Please share your goals, roles, accomplishments, programs and plans. Please be concise.
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Other 4-H Activities Summary
List information on activities not reported elsewhere in this application. Please be sure to include the role of your participation. Please be concise.
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Non 4-H Activities
Please list activities you are involved in outside of 4-H and what your role is
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4-H Project or Activity Report
Knowledge, skills, size, scope, experiences and leadership.
Describe the leadership and or teaching responsibilities you have had in a specific project or activity. Please be sure to state the project or activity.
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