2019 Emerald Award Application

2019 4-H Emerald Achievement Award Application

(formerly the 4-H Key Club Award Application)

Name (Please Print ) _____________________________________________ AGE __________________

(First)(Middle)(Last)

Parish ______________________________________________School __________________________

Address _________________________________Parent’s Name _________________________________

All items are optional, but a total of 360 points must be earned for award.Points are accumulated based on your total years of work in 4-H.

The basic requirements are as follows:
1. Must be 15 years of age by January 1 of the year application is made.
2.Must have three years of 4-H club work, including award year.
3.Must have completed one year of active Junior Leadership work excluding award year.
4.Must score at least 360 points on the application and scorecard.
5.A club member can only win this award one time.

ACTIVITY

NUMBER

POINTS PER NUMBER

MAXIMUM PTS.

PTS. EARNED

Years of 4-H Club Work

10

70

Number of years of completed Jr. Leadership work. (Must have been a paid member and have participated in at least 4 meetings per year)

10

40

4-H Officer positions in your local club

List officers positions

1._________________________

2._________________________

3._________________________

10

30

4-H Officer positions in your Jr. Leadership Club.List Office:

  • _________________________

10

10

Number of years you followed through with at least one project and submitted record book for parish judging.

List projects

1._________________________

2._________________________

_________________________

10

30

State 4-H Records Contest

15

15


Number of 4-H Presentations given before a civic group or local governing body

List presentations:

1._________________________

2._________________________

3._________________________

10

30

Service-Learning project(s) completed in the last 3 years, which included Youth Voice, Service, Education, and Reflection/Evaluation.

Name the Service Project

10

10

Number of years in Parish Achievement Day/Contest Day/ Parish Fun Day/Parish Awards Day

10

50

Number of years served on Parish Advisory Committee, Parish Foundation Committee or Parish Leadership Council.

5

10

Number of years participated in 4-H University

10

40

State or district events (such as JLC, Regional Cookery, 4-H Day at Capitol, Ag Awareness, etc.

Name the event and year

Event

Year

10

60

Number of Workshops presented as a Junior Leader

List the workshops

1.__________________________

2.__________________________

15

30


Number of 4-H exhibits in competition (can include livestock, food items, clothing items, etc.)

List the items:

1._______________________________

2._______________________________

3._______________________________

10

30

Leadership Activities:

Years Served as Camp Counselor

Years Served on Regional or State Board

10

10

20

20

TOTAL POINTS AVAILABLE

480

TOTAL POINTS EARNED

(MUST BE 360 OR MORE)

_____________

A club member can only win this award one time.

Applicants must score at least 360 points to be eligible for consideration and 15 years of age or older on January 1 of the current year.

I have personally prepared this report and believe it to be correct.

______________________________________________________

(Signature of Club Member)

I have reviewed this report and believe it to be correct.

_____________________________________________________

Signature of Parent or Guardian)

1/10/2019 4:30:42 PM
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