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Home / Award Application Form

Award Application Form

Bastrop County 4-H Award Application

2017-2018

Award Application:*
- Gold Star (2) - Must be at least 15 as of August 31 of current 4-H year
- Silver Star (1) - Senior age 4-H members
- I Dare You (1) - Must be at least 9th grade as of August 31 of current 4-H year
- Bronze Star - Must be Intermediate. Requires an Interview June 26, 2017.
- Outstanding Junior (2)
- Outstanding Intermediate (2)
- 4-H Jacket - 1st place at what District or State 4-H event? Please list in the space below.
4-H Jacket : 1st Place at what District or State 4-H event?
Applicant's Name:*
First Last
Nickname, if any:
Address:*
Street Address City State ZIP Code
Parent or Guardian's Name:*
First Last
Phone:*
Email:*
Date of Birth:*
Grade:*
Please enter a number from 1 to 12.
Gender:
- Male
- Female
Name of 4-H Club:*
- Bastrop 4-H
- Bastrop Bulls Eyes Shooting Sports 4-H Club
- Bastrop Veterinary Science 4-H Club
- Brush Poppers 4-H Club
- Loblolly 4-H Club
- Lone Star 4-H Club
- Rockne 4-H Club
- Smithville 4-H Club
My record book this year was entered in the following Awards Programs:*
List 4-H projects you completed (indicate number years in each project):*
What do you consider your most outstanding 4-H project and why?*
List the activities in which your have participated (such as educational presentations, judging contests, camps, leadership labs, state and national activities:*
List your 5 most outstanding leadership experiences (club, county, district, offices held, committee work):*
List your 5 most outstanding community service activities in which you participated:*
List your 5 most important 4-H honors and recognition:*
Program Narrative in 100 words or less (see example on the Gold Star Program Narrative Instructions):*

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