Each 4-H member should complete one "My 4-H Year" record sheet per year.

Download Fillable/Printable PDF Record Book Sheet

4-H Year:__________________________

Attach a picture  of you from this year to this page

This Record Belongs to

County

 

Club

 

Age

 

Years in 4-H

 

Grade in School

 

 

These are my projects for this year

 

 

 

These are my goals for this year

Briefly describe your goals for the coming year. Use only the space provided. Use your tab key to move to the next line.

 

 

Did you reach your goals?

Briefly describe what happened throughout the year as you attempted to reach your goals. Use your tab key to move to the next line.

 

 

Club & Project Club Meeting Participation

Record the number of club & organized project meetings you attend. Add notes as needed.

 

Oct

Nov

Dec

Jan

Feb

Mar

Apr

May

Jun

Jul

Aug

Sep

Club Name Example Club

1

1

No Meeting

1

Missed Meeting

-Sick

2

1

1

No Meeting

2

1

1

Club/Project Name

 

 

 

 

 

 

 

 

 

 

 

 

Club/Project Name

 

 

 

 

 

 

 

 

 

 

 

 

Club/Project Name

 

 

 

 

 

 

 

 

 

 

 

 

Club/Project Name

 

 

 

 

 

 

 

 

 

 

 

 

Club/Project Name

 

 

 

 

 

 

 

 

 

 

 

 

 

Offices & Committees (4-H and other)

Record club offices you hold and committees you are a member of. If you need more space, use the extra pages at end of this record form, and check the box below.

Name of Committee or Office

Describe what you do

 

 

 

Promotional Presentations

Record ways you have promoted or publicized 4-H (examples: wore my club t-shirt, National 4-H Week booth, published a news article, etc.). If you need more space, use extra pages at end of this record form, and check the box below.

Type of Presentation

Description

Event or Location

Date

 

 

 

 

 

Communications Activities

Record your communications activities. (examples: Demonstration/Illustrated Talk, Kiwanis Report, reports at club meetings, public speaking, etc.) If you need more space, use extra pages at end of this record form, and check the box below.

Type of Communication

Title

Event or Location

Date

 

 

 

 

 

Awards & Honors (4-H and other)

Record ALL awards and honors that you have received this year. Include both 4-H and other, such as school, sports, community etc. If you need more space, use extra pages at end of this record form, and check the box below.

Activity or Event

Award

Location

Date

 

 

 

 

 

Journal of Activities, Events & Experiences

Use this page to record ALL activities, events, and experiences as you have them. Include things such as school, sports, church, home chores, civic and volunteer activities. If you need more space, use extra pages at end of this record form, and check the box below.

Type of Activity

Location

Description

Date

 

 

 

 

 

Comments

Record notes or other comments you have about the experiences you have had this year in 4-H. If you need more space, use extra pages at end of this record form, and check the box below.

 

 

Club Member Signature

I have evaluated my records and believe that they are accurate, complete and verify that this represents my own work.

 
Club Leader Signature

I have reviewed this record book.

 

Lewis & Clark County Extension
100 W. Custer Ave
Helena, MT 59602

(406) 447-8346

Administrative Support
Lexi Foust
(406) 447-8346
lewisclark@montana.edu

Family Consumer Science/Community Development Agent
Shae Bruursema
(406) 447-8042
shae.bruursema@montana.edu

SNAP-Ed Agent 
Chloé Lundquist
(406) 447-8456
chloe.lundquist@montana.edu

Agricultural and Natural Resources Extension Agent
Vacant

4-H and Youth Development Extension Agent
Vacant