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- 4-H Golden Clover Award Application (formerly 4-H Award of Excellence)
The 4-H Golden Clover Award Application
(formerly the 4-H Award of Excellence)
Name (Please Print ) __________________________________________________ AGE __________________
(First)(Middle)(Last)
Parish ______________________________________________School _______________________________
Address ________________________________________ Parent’s Name ______________________________
All items are optional, but a total of 250 points must be earned for award. Points are accumulated based on your total years of work in
4-H.
The basic requirements are as follows:
1.Must be 14 years or under by January 1 of the club year application is made.
2.Must have at least two (2) years of 4-H club work, including award year.
3.Must score at least 250 points on the application scorecard.
4.This award can only be won by the 4-H member one time.
| ACTIVITY | NUMBER | POINTS PER NUMBER | MAXIMUM PTS. | PTS. EARNED |
| Number of years as a 4-H Club member including this year. (20 points for two years and 5 points for each additional year.) |
| 10/5 | 25 |
|
| Held a 4-H Office in your local club List offices held 1._________________________ 2._________________________ |
| 5 | 10 |
|
| 4-H Project records (completed all activities in project book and submit to parish). 1._________________________ 2._________________________ 3._________________________ 4._________________________ |
| 5 | 20 |
|
| Competed in State 4-H Records |
| 15 | 15 |
|
| Workshops/clinics 1._________________________ 2._________________________ 3._________________________ 4._________________________ 5._________________________ 6._________________________ 7._________________________ 8._________________________ 9._________________________ 10._________________________ |
| 5 | 50 |
| ||||||||||||||||||||||||||||||||||||
| Number of years participated in Parish Achievement Day/Contest Day/ Parish Fun Day/Parish Awards Day |
| 10 | 40 |
| ||||||||||||||||||||||||||||||||||||
| Quality 4-H project exhibits or presentations
(5 points for each 1st-3rd place won) | | 5 | 40 |
| ||||||||||||||||||||||||||||||||||||
| 4-H Summer Camp/Challenge Camp or other Project related camps Camp NameYear
|
| 5 | 20 |
|
| State and district events (Such as Regional Cookery, 4-H Day at the Capital, Ag Awareness, etc.)
|
| 10 | 60 |
| ||||||||||||||||||||||||||||||||||||||||||||
| Help given on behalf of 4-H
|
|
3 |
30 |
| ||||||||||||||||||||||||||||||||||||||||||||
| Local 4-H club activities such as Safety, Community Drives, Citizenship activities, etc.
|
|
3 |
30 |
| ||||||||||||||||||||||||||||||||||||||||||||
| TOTAL POINTS AVAILABLE | | | 350 |
| ||||||||||||||||||||||||||||||||||||||||||||
|
TOTAL POINTS EARNED (MUST BE 250 OR MORE) |
|
|
|
_______ |
This award can only be won by the 4-H member one time.
I have personally prepared this report and believe it to be correct.
______________________________________________________
(Signature of Club Member)
I have reviewed this report and believe it to be correct.
_____________________________________________________
Signature of Parent or Guardian)
