2016 White County Community Involvement Award Application Name Club Date of Birth Age on Sept. 1, 2015 Years in 4-h sept. 1, 2015 – August 31, 2016 Award Year



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2016 White County Community Involvement Award Application

Name Club

Date of Birth Age on Sept. 1, 2015

Years in 4-H Sept. 1, 2015 – August 31, 2016 Award Year

There are two divisions for this award:



Junior (age 8-12)

Senior (age 13-18)

Cash prizes are awarded for 1st3rd places in each division.



INSTRUCTIONS:

  1. Write and attach a story about the topic listed below:

Write an essay about all your involvement in the community this past year. Then, focus on one service project of your choosing and give more details about your work and results.




  1. Submit your 4-H Highlights form.




  1. Include signatures from the member, parent and leader.



I have prepared this application and certify that it is an honest account of my work.


4-H Member’s Signature
I have reviewed this application and believe it to be an honest review of the 4-Her’s work.

4-H Parent’s Signature
4-H Leader’s Signature

Revised 8/1/09



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