1. STANLY COUNTY 4-H AWARDS APPLICATION
NAME OF AWARD: __________________________________________________
(Example: Outstanding Sr. Girl/Boy (13-19 years old); Outstanding Jr. Girl/Boy (9-12 years old);
4-H Spirit Award – New 4-H’er, 1 year & 6 months or less as of Achievement Night)
Name: ______________________________________ 4-H Club: _________________________________
Date of Birth: _____________________________ Years in 4-H: _______________
PROJECT BOOKS COMPLETED THIS YEAR:
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ALL INFORMATION BELOW SHOULD BE LISTED FOR 2008 YEAR ONLY.
4-H Leadership Activities: (Club, County, District, State; Include offices held, programs presented, Jr. Leader roles, etc.)
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4-H Community Service Activities: ____________________________________________________________
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County, District & State Activities: (Presentations, Talent/Fashion Show, Fair, Camp, Winter Enrichment,
Teen Retreat, Congress, Livestock Contests, etc.)
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Comments: _______________________________________________________________________________
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ON THE BACK, Please complete the following statement in your own handwriting:
“What 4-H Means to Me”
(For club leaders nominating 4-H’ers, please attach a statement about why you feel the above
named person should receive a 4-H award.)
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Signature of 4-H’er Signature of 4-H Leader

2. NOTE: This application will be used to determine the Outstanding 4-H’er Awards, which will be presented
at Achievement Night. 4-H’ers are only eligible to receive each award one time.
This form is due to the 4-H Office by Wednesday, February 17, 2009.
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