Cumberland County 4-H Recognition Award Program APPLICATION INFORMATION - SENIOR DIVISION

Transcription

1 DEAR 4-H MEMBER: Cumberland County 4-H Recognition Award Program APPLICATION INFORMATION - SENIOR DIVISION Welcome to the Cumberland County 4-H Recognition Award Program. This application is your ticket to recognition at the county, state, and national level. Senior division members need to submit this application along with two recommendation forms. Applicants are eligible for recognition at the county 4-H Achievement Night. Cumberland County will send two delegates to National 4-H Congress tentatively scheduled for November of the current year. Applicants for National Congress must be at least 15 years old as of the current year and must be at least a third year 4-H member. 4-H members may be eligible for individual club awards based on the completion of the 4-H Recognition Form. Application Criteria To compete in the Senior Division of the 4-H Recognition Award Program, 4-H members must be years of age as of January 1 of the current program year. Application Guidelines Applications should include two recommendation forms, at least one of which must be completed by a non-4-h-related person (e.g., teacher, employer, counselor, coach, minister, church youth advisor). Do not ask members of your immediate family to complete recommendation forms. Please print in black ink or type. You may use a word processor or computer, but you must keep the same format and include all the information printed on the original, including the Affirmative Action statement. List your answers in the space provided. Do not add extra pages. If typing, please double space and do not use a font size smaller than 10. Application Deadline Recognition Award applications are due September 1 (excluding National Congress applicants). Your recommendation letters must be included with the application or received at the Extension Office by September 1. Applications for National 4-H Congress are DUE June 1.

2 Cumberland County 4-H Recognition Award Program Application Score Sheet - Senior Division Possible Points Your Score Project Summary Project Resume (attached page) Question 1 Question 2 Question 3 Question 4 - Essay Two completed recommendation forms 5 points 20 points 10 points 10 points 10 points 25 points 20 points TOTAL SCORE: 100 points

3 CUMBERLAND COUNTY 4-H RECOGNITION AWARD PROGRAM APPLICATION FORM - SENIOR DIVISION Name Address Project Area County City State Zip Male Female Years in 4-H Phone Number( ) Age as of January 1 of this year Date of Birth / / Name of Parent(s) or Guardian(s) Name of 4-H Club(s) or Program(s) Name of 4-H Leader(s) Are you currently enrolled in high school, college, or a vocational program? Yes No If so, what is the school's name? What year are you in? What is your major area of study? If you are not in school, what is your present job or career? I have personally prepared this application and believe it to be accurate. Member's Signature Date / / My signature below indicates that I have read this application and believe it to be correct. I certify that this individual is a current active member of the 4-H Program, and I approve this application for submission into the Cumberland County 4-H Recognition Award Program. Parent's / Guardian's Signature Date / / Local 4-H Leader's Signature Date / / County Extension Educator s Signature Date / / This publication is available in alternative media on request. The Pennsylvania State University is committed to the policy that all persons shall have equal access to programs, facilities, admission, and employment without regard to personal characteristics not related to ability, performance, or qualifications as determined by University policy or by state or federal authorities. It is the policy of the University to maintain an academic and work environment free of discrimination, including harassment. The Pennsylvania State University prohibits discrimination and harassment against any person because of age, ancestry, color, disability or handicap, national origin, race, religious creed, sex, sexual orientation, or veteran status. Discrimination or harassment against faculty, staff, or students will not be tolerated at The Pennsylvania State University. Direct all inquiries regarding the nondiscrimination policy to the Affirmative Action Director, The Pennsylvania State University, 328 Boucke Building, University Park, PA , Tel /V, /TTY.

4 PROJECT SUMMARY List the 4-H projects that you have completed in each of the previous two 4-H years. Include the complete name of the project and the unit level. Year Year _ List the 4-H projects that you are enrolled in this year. PROJECT AND PARTICIPATION RESUME Attach a one-page description of your accomplishments and experiences in 4-H. Focus your description on your current year's accomplishments and those of the two previous years. Include the goals that you have achieved, knowledge and skills acquired, special 4-H events, activities, programs that you have attended, etc. You need NOT list your projects again. Use only one side of one page, and type your resume if possible. Resumes should be in traditional resume format.

5 1.Describe your two most important 4-H-related communications experiences from the current year, or two previous years (e.g., presentations, public speaking, marketing 4-H, etc.). Limit your response to the space provided. 2.Describe your two most important 4-H-related leadership experiences from the current year or two previous years (e.g., club or county offices, county or regional committees, camp counselor, etc.). Limit your response to the space provided.

6 3. Describe your two most important community service experiences from the current year or two previous years (e.g., providing service to benefit an agency or organization of 4-H). Limit your response to the space provided. 4. Attach a one-page essay explaining how your 4-H experiences have helped you make a difference in your club or county 4-H program, school, or community. Also explain how those experiences will help you contribute to a better society in the future. Use only one side on one page, and type your response if possible. All typed responses should be double-spaced.

7 CUMBERLAND COUNTY 4-H RECOGNITION AWARD PROGRAM RECOMMENDATION FORM RECOMMENDATION FOR (4-H Member) The individual above is submitting an application for recognition in the Cumberland County 4-H Recognition Award Program. The applicant is required to provide one completed recommendation form from an individual (i.e. 4-H leader, teacher, coach, guidance counselor, minister, youth group advisor, etc.) who has an understanding of the applicant's involvement in school and community activities. Your responses to the following questions will provide valuable input to the committee as they select county winners. How long have you known the applicant? How have you been involved with or how do you know the individual? Describe the contributions the individual has made to the 4-H Program, school, and/or community in which he/she lives. CONTINUED

8 Indicate leadership qualities currently exhibited by the applicant, as well as potential for future leadership development. Indicate other qualities, strengths, or special talents that you believe the applicant has. Printed name of person submitting recommendation Address Phone Signature of person submitting recommendation Date / / This publication is available in alternative media on request. The Pennsylvania State University is committed to the policy that all persons shall have equal access to programs, facilities, admission, and employment without regard to personal characteristics not related to ability, performance, or qualifications as determined by University policy or by state or federal authorities. It is the policy of the University to maintain an academic and work environment free of discrimination, including harassment. The Pennsylvania State University prohibits discrimination and harassment against any person because of age, ancestry, color, disability or handicap, national origin, race, religious creed, sex, sexual orientation, or veteran status. Discrimination or harassment against faculty, staff, or students will not be tolerated at The Pennsylvania State University. Direct all inquiries regarding the nondiscrimination policy to the Affirmative Action Director, The Pennsylvania State University, 328 Boucke Building, University Park, PA , Tel /V, /TTY.

9 CUMBERLAND COUNTY 4-H RECOGNITION AWARD PROGRAM RECOMMENDATION FORM RECOMMENDATION FOR (4-H Member) The individual above is submitting an application for recognition in the Cumberland County 4-H Recognition Award Program. The applicant is required to provide one completed recommendation form from an individual (i.e. 4-H leader, teacher, coach, guidance counselor, minister, youth group advisor, etc.) who has an understanding of the applicant's involvement in school and community activities. Your responses to the following questions will provide valuable input to the committee as they select county winners. How long have you known the applicant? How have you been involved with or how do you know the individual? Describe the contributions the individual has made to the 4-H Program, school, and/or community in which he/she lives. CONTINUED

10 Indicate leadership qualities currently exhibited by the applicant, as well as potential for future leadership development. Indicate other qualities, strengths, or special talents that you believe the applicant has. Printed name of person submitting recommendation Address Phone Signature of person submitting recommendation Date / / This publication is available in alternative media on request. The Pennsylvania State University is committed to the policy that all persons shall have equal access to programs, facilities, admission, and employment without regard to personal characteristics not related to ability, performance, or qualifications as determined by University policy or by state or federal authorities. It is the policy of the University to maintain an academic and work environment free of discrimination, including harassment. The Pennsylvania State University prohibits discrimination and harassment against any person because of age, ancestry, color, disability or handicap, national origin, race, religious creed, sex, sexual orientation, or veteran status. Discrimination or harassment against faculty, staff, or students will not be tolerated at The Pennsylvania State University. Direct all inquiries regarding the nondiscrimination policy to the Affirmative Action Director, The Pennsylvania State University, 328 Boucke Building, University Park, PA , Tel /V, /TTY.