2022 4-H Participation (for Achievement Program Certificates)

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Youth will be recognized for their 2022 4-H participation and achievements at our upcoming Achievement Program. Please answer the questions below in order for your child to receive an accurate certificate at our Achievement Program. Please check all 4-H events/clubs that youth participated in for 2022 (only include 2022 participation; do not include what they may have done in years prior).

Please complete this form no later than February 10, 2023.

Email *

Name of person filling out this form: *

4-H'er Name: *

Club(s) 4-H'er was a member of in 2022: *

At-Large 4-H member (a 4-H'er who is not a member of a 4-H club)

Happy Trails

Hot Shots

Lead Drivers

Rowan Rolling Pins

West Rowan 4-H Explorers

Required

If your child was a member of multiple clubs in 2022, which do you consider as his/her primary club? *

The 4-H'er was only in one club OR was an at-large member.

Happy Trails

Hot Shots

Lead Drivers

Rowan Rolling Pins

West Rowan 4-H Explorers

Please indicate how many years of service the 4-H'er has had up until December 31, 2022. *

First year

2 years

3 years

4 years

5 years

6 years

7 years

8 years

9 years

10 years

11 years

12 years

13 years

14 years

15 years

Please check each of the events below that this 4-H'er participated in for 2022 (there is a NONE option at the bottom if needed): *

County Council

Summer Fun programs with Rowan County 4-H

4-H Piedmont Rabbit Project

4-H Poultry Judging

Speak Up (Rowan 4-H public speaking workshops)

Rowan County 4-H Pumpkin Decorating Contest

Rowan County 4-H Casserole Cook-off

Worked during 4-H PALS Port-a-Pit Fundraiser

Paper Clover Week at Tractor Supply

4-H Pet Supply Drive

4-H Camp participant at Betsy-Jeff Penn

South Central District 4-H Winter Enrichment (downtown Kannapolis)

South Central District 4-H Teen Retreat

South Central District 4-H Friendsgiving

Project Record Book(s)

Portfolio(s)

County Activity Day (4-H Presentation, Talent, and/or Expressive Arts)

District Activity Day (4-H Presentation or Talent)

State Presentation Finals (Raleigh, NC)

NC 4-H Citizenship Focus (Cary/Raleigh, NC)

4-H Congress (Raleigh, NC)

NC 4-H Electric Congress

YouthVoice

District 4-H Horse Show

State 4-H Horse Show

NC 4-H Horse Program Artistic Expression

NC 4-H Egg-cellent Egg Contest

Regional Shooting Sports Tournament

State Shooting Sports Tournament

4-H Arts & Crafts competition at the NC State Fair

NONE

Required

Is this 4-H'er graduating from high school in Spring 2023? *

Yes

Thank you for completing this form to assist us in recognizing your 4-H'er during our Achievement Program! We hope you'll attend the event on Friday, February 24 at 6:30 PM. Families will have to RSVP in 4-HOnline under "events". A meal will be served. If you have questions, please contact 4-H Agent Laura Allen at laura_allen@ncsu.edu or 704-216-8970.

A copy of your responses will be emailed to the address you provided.

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