4-H Logo Protected Under 18 U.S.C. 707	4-H 510

4-H Project Record

(complete this form for each project)

Use tab key to move cursor to each field. Field will expand as you type.

This Record Belongs to:	Year:

Club Name:

Junior	Intermediate	Senior	Years in 4-H Birth Date

My Project is:

Number of years in this project area:

Date project started: (Month/Day/Year)

Date this year project was completed: (Month/Day/Year)

Size of project:

Title of Project Activity Guide:

Level I,A	Level 2,B	Level 3,C	Level 4,D	Other

Year in Achievement Program Level:	Year 1	Year 2	Year 3

Number of lessons completed during the 1st year:

Number of lessons completed during the 2nd year:

Number of lessons completed during the 3rd year:

In this project, I would like to do and learn:

I have completed this record and believe all information to be complete and accurate.

Member Signature	Date	Volunteer/Leader Signature	Date

Extension Educator	Date

Project Journal/Log
Date	Communications Topic or Title	Location	Rating

Date	Exhibit(s)	Location	Rating

Learning Experiences – Include project meetings/workshops, shows, concerts, learning experiences, and anything related to your project. Record all the things as you do them.

Date	What I Did	What I Learned

Need more room? Add a page.

2

Project Financial Journal

Income is all the monies you receive from the sale of services, products, and premiums for this

4-H Project. Expenses are all the items you paid for to support this 4-H Project.

Date	Description of Income or Expense	Income	Expense
Income:	$ 0.00
Expenses:	$ 0.00
Profit (+) or Loss (-):	$ 0.00

3

List resources you used to learn more about your project. Include books, people, Internet, bulletins.

Describe the life skills you have learned /practiced in this project under each “H” of the 4-H Clover.

HEAD (managing and decision making):

HEART (relating and caring):

HANDS (giving and working):

HEALTH (living and being):

This project was . . .

This project has encouraged me to . . .

Supplemental Materials/Creative Time should be attached to your Record Sheet.

Developed by

L. Martin Hamilton

Alice Hevner

Mary Ellen Waltemire

Issued in furtherance of Cooperative Extension work, acts of May 8 and June 30, 1914, in cooperation with the U.S. Department of Agriculture, University of Maryland, College Park, and local governments. Thomas A. Fretz, Director of Maryland Cooperative Extension, University of Maryland.

The University of Maryland is equal opportunity. The University’s policies, programs, and activities are in conformance with pertinent Federal and State laws and regulations on nondiscrimination regarding race, color, religion, age, national origin, sex, and disability. Inquiries regarding compliance with Title VI of the Civil Rights Act of 1964, as amended; Title IX of the Educational Amendments; Section 504 of the Rehabilitation Act of 1973; and the Americans With Disabilities Act of 1990; or related legal requirements should be directed to the Director of Personnel/Human Relations, Office of the Dean, College of Agriculture and Natural Resources, Symons Hall, College Par, MD 20742.

P2000

4-H Project Record

Washington County

2001-06-24

Jake Thompson

UMD-AGNR