Waldo County 4-H Program Impact Form
Submit: Either as you experience success or an annual report by the first Tuesday in September
Full Name Email Phone Become Responsible and Involved Citizens How many total hours per week, in general, do your leaders volunteer in citizenship and community service? Example: If there are 3 volunteers in your club and one volunteers four hours, and the other two each volunteer one hour, the total is 6 hours. Action 1: Have conducted a community service or outreach. Number of youth in your club or group: Number of youth completing this action: Briefly, what was it? Action 2: Work productively in a team. Number of youth in your club or group: Number of youth completing this action: Briefly, give one or more examples. Apply Science and Technology Skills How many total hours per week, in general, do your leaders volunteer in Science areas? Example: If there are 3 volunteers in your club and one volunteers four hours, and the other two each volunteer one hour, the total is 6 hours. Action 3: Have increased knowledge and/or skills in animal or environmental science, engineering, or technology content or career development. Number of youth in your club or group: Number of youth completing this action: Briefly, give one or more examples. Action 4: Participated in environmental or natural resource conservation education. Number of youth in your club or group: Number of youth completing this action: Briefly, give one or more examples. Action 5: Has your club or group completed any projects this 4-H year related to Science, Engineering or Technology (SET)? Number of youth in your club or group: Number of youth completing this action: Briefly, give one or more examples.
Become Responsible and Involved Citizens How many total hours per week, in general, do your leaders volunteer in citizenship and community service? Example: If there are 3 volunteers in your club and one volunteers four hours, and the other two each volunteer one hour, the total is 6 hours.
Become Responsible and Involved Citizens
How many total hours per week, in general, do your leaders volunteer in citizenship and community service? Example: If there are 3 volunteers in your club and one volunteers four hours, and the other two each volunteer one hour, the total is 6 hours.
Action 1: Have conducted a community service or outreach.
Number of youth in your club or group: Number of youth completing this action: Briefly, what was it?
Number of youth in your club or group:
Number of youth completing this action:
Briefly, what was it?
Action 2: Work productively in a team.
Number of youth in your club or group: Number of youth completing this action: Briefly, give one or more examples.
Briefly, give one or more examples.
Apply Science and Technology Skills
How many total hours per week, in general, do your leaders volunteer in Science areas? Example: If there are 3 volunteers in your club and one volunteers four hours, and the other two each volunteer one hour, the total is 6 hours.
Action 3: Have increased knowledge and/or skills in animal or environmental science, engineering, or technology content or career development.
Action 4: Participated in environmental or natural resource conservation education.
Action 5: Has your club or group completed any projects this 4-H year related to Science, Engineering or Technology (SET)?