4-H Achievement Applications (Record Books)

• Name: (First | Middle | Last)
• Address:
• City:
• State: Nebraska
• Zip Code:
• 4-H Membership County:
• Home Phone:
• Cell Phone:
• Email Address:
• Date of Birth: (Month | Date | Year)
• School:
• Current Age:

(By inserting initials below, we certify that the information in this application is accurate and complete.)

• Applicant (Typed initials):
• Date:
• Parent/Guardian (Typed initials):
• Date:

• Please respond to categories 1-4 within a maximum of four pages.
• Please label responses with the section heading. (4-H Experiences, Leadership, Community Involvement, Spark)
• Creativity is strongly encouraged. Feel free to include lists, photos, infographics, etc. to help tell your 4-H story.
• The questions in each section are designed to provide inspiration and an idea of what reviewers may consider.
• It is not necessary to address every suggestion or question in your responses(s).
• Significant accomplishments in (and learning from) your 4-H Experiences, Leadership, Community Involvement, Spark are given priority consideration over the number of 4-H projects completed.

• Describe your collective 4-H experience.
• Identify three program experiences that you consider “highlights” of your 4-H experience.
• What skills have you learned as a result of being a part of 4-H?
• What have you learned about yourself as a result of being a part of 4-H?
• How will your 4-H experience influence your future?

• Describe your 4-H leadership experiences that have helped build your leadership skills.
• What type of leadership was it? Roles (Club President) | Activities (4-H Lend-a-Hand Day) | Experiences (Junior Ambassador)
• Identify your role in the experiences, the duties you completed, responsibilities you fulfilled and skills you utilized.
• Describe any non-4-H leadership experiences that have helped build your leadership skills.
• What did you learn about leadership through all of your leadership experiences?

• Describe times you were involved in volunteer service to others and/or the community through 4-H or other opportunities.
• List the type of involvement.
• What were the duties, responsibilities and skills you used to be successful?
• What did you learn from each of your experiences?

• Describe how your 4-H experiences have sparked your interest in a future career field.
• What has 4-H “sparked” in you that you are curious to explore (both academically and in extra-curricular activities) in middle school, junior high, high school, or beyond?
• How do you see yourself contributing professionally to your community in the future? How has 4-H influenced how you see yourself in this future role?
• Explain any experiences you have pursued in connection with your career spark. Have you been a part of any formal or informal mentorships, job shadows or interviews related to potential career interests?