List position held: List position held: List position held: 2 pts. per meeting - January-December
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1 Brunswick County 4-H Achievement Program Outstanding 4-H'er Award Form Eligibility: 4-H members who are 9-18 years of age January 1st of the year (2012). Information & participation is for the period of January 1st-December 31st of the H year. Age Categories: 9-10, 11-12, and WIN $100 towards 4-H events!! Add your bio and banquet RSVP at the end Deadline: due in the 4-H office by February 15th The spreadsheet is created so that each category adds your score automatically for you. Please place an "X" in Column A if you participated. If the "Your Info" column is highlighted, you need to enter what you did or how you placed in the competition. Pay attention to the bolded info. Name: Home Phone Number: Date of Birth: Address: 4-H Age (age as of January 1, 2012): X Points Earned Extra Notes Your Info 1 Leadership H Club Officer (not teen council) 10 List position held: 4-H Club Committee Member 5 List committee: County Officer Training 5 January 23rd List position held: List position held: List position held: 4-H Teen Council Officer 15 District 4-H Teen Council Officer 20 State 4-H Teen Council Officer 25 Brunswick County Teen Council # of Co. Council Meetings Attended 10 TiLT Retreat 15 February 10th-12th TiLT Camp Counselor/Leader 20 TiLT Leader in Training 10 TiLT Workday 10 Other district or regional officer 8 2 Projects & Records 60 0 County Project Record Book 20 List categories: District Project Record Book 10 List categories: County Cumulative Record 10 List categories: District Cumulative Record 10 List categories: State Cumulative Record 10 List categories: 3 Sewing 40 0 Spring Sewing Workshop 10 March 5th, 12th, 19th, April 2nd County Fashion Revue 10 May 18th State MIWW 10 September 8th 2 pts. per meeting - January-December 2 pts. per camp days taught or helped to lead (see section 9 for camp days) 5 pts for ea workday Based upon the H year. Add 5 points for each additional project.
2 National MIWW 10 4 Presentations 70 0 County 4-H Entertains (Talent Show) 10 May 2nd County Activity Day Presentation 10 April 11th District Activity Day Presentation 10 June 22nd DAD Poster Contest 10 June 22nd District 4-H Entertains (Talent Show) 10 June 22nd State Level Presentation 10 Any other presentation you gave: 10 List title & location: 5 County Fundraisers 10 0 Attractions Coupon Books 10 Ongoing 6 Trips & Camps 52 0 Southeast District Teen Retreat 10 State Council Conference 10 4-H BetsyJeffPenn 10 Cooperative Leadership- ATMC 10 4-H Congress 12 7 Environmental Education 50 0 Soil & Water Contests 10 5 pts per contest Coastal Envirothon 10 State Envirothon 10 WHEP State Competition 10 Cape Fear Wildlife Expo 10 5 pts a day 8 Animal Science 40 0 Dairy Poster 10 Beef Poster 10 Beef Ambassador Program 10 Beekeeping Essay 10 9 Summer Enrichment Activities 54 0 March 9th-10th November 3rd and 4th July 29th-August 3rd June 18th-22nd July 18th-21st (3 pts per day attended) due in February This section is only for paid campers NOT TiLT teens Clover-bud Super Hero in Training 2 June 18th Super Heros in Training Week 6 June 19th-21st 2 pts per day Clover-bud Super Star Camp 2 June 25th Super Star Week 6 June 26th-28th 2 pts per day Clover-bud Super Explorers Day 2 July 2nd Clover-bud Super Shamrock Chef Day 2 July 9th Super Shamrock Chef Week 8 July 10th-12th add 2 pts per day and 2 extra point if you won 1st place Clover-Bud Local Super Hero Day 2 July 16th Clover-Bud Horse Camp 2 July 23rd Super Farm Day NC State 2 July 25th
3 Super Farm Day Horse Camp 2 July 26th Clover-bud Design Squad Hero 2 July 30th Super Electric Science Day 2 August 2nd Clover-bud Aqua Man Camp 2 August 6th Super Soaker Science Day (Sea Turtle) 2 August 7th Super Soaker Science Day (Fort Caswell) 2 August 8th Super Soaker Science Days (Overnight Aquarium 4 August 10th-11th 2 pts per day Clover-bud Super Career Heros 2 August 13th Moon Bounce Party 2 August 14th 10 Community Service 56 0 Relay for Life 6 Hungry to Help 9 Reading Makes the Best Better 3 School Visits (promoting 4-H) 12 3 pts. Per visit: List school(s): Special Olympics 3 April 20th Southport Elementary PTA 3 November 15th 3 pts. Per visit: List school(s): CalciYum 15 List other service project(s): 5 11 Citizenship/ Personal Development Citizenship Focus 15 Inducted into 4-H Honor Club 25 4-H Ambassador Program 20 Career Poster 5 ARIE Contest 15 Nat'l 4-H Week CalciYum/NYSD experiment/lof 5 5 pts for each activity NYSD experiment schools 5 Club Member 5 List club name 1 Pt. per hour up to 10 hours 4-H Office Intern: # of hours 10 List other citizenship or personal dev Electric Program 20 0 Electric Workshop-Wayne County 5 Electric Congress County & State Fairs 57 0 NC State Fair-Photo Contest 5 NC State Fair-Crafts 5 NC State Fair-Animal exhibits 8 Cape Fear Fair-Photo Contest 5 Cape Fear Fair-Baked goods 5 3 pts. per day (May 4th-5th) 3 pts. per event (National 4-H week, summer fun donation, other) June 11th - 13th 5 Bronze, 10 Silver, 15 Gold, 20 Emerald May 15th Add 2 points for each additional project.
4 Cape Fear Fair-Sewing/garments 8 Cape Fear Fair-Crafts 5 Cape Fear Fair-Animal exhibits 8 Cape Fear Fair-Educational Booth 8 14 Photography / Art 13 0 State Photography Contest 8 OMK Photo Contest 5 15 Horticulture 22 0 Horticulture Judging Team 10 National Horticulture Judging Team Poultry 68 0 Embryology 10 Individual project enter date for NC State Fair Poultry Judging Team 8 Turkey Project 20 Poultry Science Institute 25 Poultry Poster 5 17 Livestock Judging, Contest, Clinics 36 0 Meat Goats Contest 12 Sheep Contest 12 Beef Contest Workshops 3 0 Sugar Cake Workshop 3 December 21st 19 Equine 65 0 District Horse Quiz Bowl 5 January 28th Horse Judging and Hippo Training 5 February 4th State Horse Quiz Bowl 10 March 3rd Horse Drawing Contest 5 Horse Photo Contest 5 Horse Poster Contest 5 Horse Writing Contest 5 May 5th October 5th-7th for NC State Fair 3 pts for each judging or event; please list District Horse Show 10 May 19th-20th State Horse Show 15 July 11th-15th TOTAL SCORE Please submit this form by the deadline, February 15th copied forms by to: angie_lawrence@ncsu.edu gina_britton@ncsu.edu, paper copies Mail to - 4-H Staff, P.O. Box 109, Bolivia, NC 28422, Fax Copies to
5 4-H Bio (Include club, offices, project, age, grade and interest) Revised Achiement Banquet Thursday March, 7th RSVP 4-H youth Parents Only RSVP your parent or sibling on one form if you have a brother or sister filing out a form:)
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